M1903 Long-Term Outcome of Treatment-NaïVE Chronic Hepatitis B (CHB) E Antigen-Negative Treated With Entecavir 0.5 Mg (ETV) or Adefovir 10 Mg (ADV) in a Real-Life Community Setting

PURPOSE:Data from registration trials have shown that CHB patients response well to antiviral therapy with antiviral resistance as the primary reason for treatment failure. However, patients seen in these settings may differ from real-life settings as they are generally carefully selected and followed closely with rigid study protocols. Our goal is to examine long-term outcomes of CHB treated with ETV or ADV in a real-life setting. METHOD:We performed a retrospective cohort study of 190 consecutive eAgpatients started on either ETV(n= 108) or ADV(n=82) between 1/02-1/09 at 2 community U.S.GI clinics. Annual/cumulative outcome variables were analyzed and reported in both cohorts. Patients were excluded from analysis if they developed resistance(n=11), started on alternate treatment(n=24), increased ETV dose(n=4), noncompliant(n=15), and/or lost to F/U(n=11). RESULTS:All patients were Asians; the majority being male.Both cohorts had similar age(52±11), median baseline ALT(62 vs.77 U/L,p=0.94) and mean baseline HBV DNA (5.6±1.3vs.5.±1.7 IU/mL,p=0.10). Table 1&2 summarized treatment outcome of both groups.By year 4, similar proportion of ETVA however, more patients in the ADV cohort failed monotherapy treatment (27%vs.5%).No patient in ETV cohort developed resistance while 18% of the ADV cohort did by year 4. Cumulative noncompliance rates were 12-13% for both cohorts. CONCLUSION:In our cohorts, monotherapy failure rate was due to both viral resistance(ADV) and noncompliance (ADV&ETV). Attention to medical compliance in addition to antiviral resistant surveillance is needed in a real-life setting.