Real life adherence of chronic hepatitis B patients to entecavir treatment

BackgroundReal-life prospective data on adherence to nucleos(t)ide analogues in chronic hepatitis B patients are scarce.AimsWe investigated adherence to entecavir in relation to virological response.MethodsIn 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.ResultsAdherence 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).Conclusions70% 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.