Real life adherence of chronic hepatitis B patients to entecavir treatment

Background: Real-life prospective data on adherence to nucleos( t)ide analogues in chronic hepatitis B patients are scarce. Aims: We investigated adherence to entecavir in relation to virological response. Methods: In this prospective study, we provided 100 consecutive chronic hepatitis B patients with a medication dispenser that monitored entecavir intake during 16 weeks therapy. Hepatitis B virus (HBV) DNA was measured at baseline and after 16 weeks. Beliefs about medicines were evaluated using a questionnaire. Results: Adherence over 16 weeks averaged 85 +/- 17%, with 70% of patients exhibiting good (i.e. >= 80%) adherence. Patients with poor (i.e. <80%) adherence were significantly younger (p =0.01), with more often indifferent attitudes towards entecavir (p = 0.03) Viral breakthrough did not occur during the study. Adherence in patients with HBV DNA after 16 weeks >20 IU/mL (n= 18) and <= 20 IU/mL (n = 81) averaged 83% and 91% respectively (p = 0.19). In multivariate analysis, adherence was not a significant predictor of HBV DNA negativity (adjusted OR 1.02; p = 0.34), after adjustment for duration of entecavir treatment (p < 0.001) and HBe-status (p = 0.001). Conclusions: 70% of chronic hepatitis B patients exhibited good adherence to entecavir, with younger age and an indifferent attitude being risk factors for poor adherence. Poor adherence was not an independent predictor of virological response. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.