It was intended to assess the efficacy of lamivudine, entecavir, and tenofovir regimens in the management of chronic hepatitis B (CHB) guided by Fibrosis-4 (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI) scores.
MATERIALS AND METHODS:

Our study was conducted on patients who applied to the hepatitis outpatient clinic between 2008 and 2015 retrospectively. Lamivudine, entecavir, and tenofovir regimens used in the practice of CHB cases were compared by measuring noninvasive FIB tests.
RESULTS:

Entirely 199 patients involved in the research were evaluated in three treatment arms; 48 used lamivudine, 46 used entecavir, and 105 used tenofovir. Similar statistical characteristics were observed between research arms regarding age, gender, and alanine aminotransferase normalization by years (P > 0.05). Totally 5 (13.5%) of patients developed Hepatitis B e antigen (HBeAg) seroconversion among 36 HBeAg positivity, and similar statistical features were seen by comparing the groups (P > 0.05). In the entecavir and tenofovir arms, a significant decrease was seen in FIB-4, and APRI index values in the 1st year of treatment (P < 0.001). At the graph curve, a plateau was observed in the APRI test after the 1st year, and a plateau was observed in the FIB-4 test after the 2nd year.
CONCLUSION:

Consistent with the study outcome, when we consider FIB regression, tenofovir and entecavir regimens were found more effective than lamivudine. In addition, entecavir was more effective than the other two drugs after the 1st year.
Keywords: Aspartate aminotransferase-to-platelet ratio index, fibrosis-4, hepatitis B
Go to:
Introduction

When the decision to start and then evaluate the treatment outcomes is concerned, a liver biopsy may bring some disadvantages in chronic hepatitis B infection (CHB). Complications that may be contraindicated for biopsy, such as ascites and coagulopathy, repeat biopsy necessity in monitoring treatment responses can be given as examples. Today, the accepted method to evaluate the fibrosis (FIB) stage of the lever in CHB is liver biopsy.[1] However, besides being a painful procedure, it can rarely cause life-threatening complications as it is an invasive procedure. In addition, it does not provide a dynamic evaluation of the histopathology of the liver after treatment. Hence, more studies are needed on the validity of noninvasive methods such as FIB-4 and aspartate aminotransferase-to-platelet ratio index (APRI) tests instead of histopathological evaluation.

The study was intended to assess treatment efficiency by comparing the FIB-4 and APRI tests in patients with CHB who received lamivudine, entecavir, and tenofovir regimens.