Entecavir therapy in a hepatitis B-related decompensated cirrhotic patient

South Med J. 2008 Nov;101(11):1173-6. doi: 10.1097/SMJ.0b013e318182a9fa.


A 58-year-old Arab-American male with HBeAg-negative chronic hepatitis B (HBV), presented with decompensated cirrhosis and a high HBV DNA level. He responded to entecavir with a significant reduction in serum HBV DNA level after 15 weeks of therapy with entecavir. However, he developed a progressive rise in prothrombin time/international normalized ratio (PT/INR) and bilirubin and underwent liver transplantation after receiving 22 weeks of entecavir therapy. Furthermore, with the continued use of combination entecavir and hepatitis B immunoglobulins (HBIG), he showed improvement in his clinical status with a nondetectable serum HBV DNA level 12 weeks after transplantation. He continued to maintain nondetectable serum HBV DNA 2 years following transplantation. To the best of our knowledge, this is the first reported case of a patient with decompensated chronic HBV who responded to entecavir both before and after transplantation without showing any evidence of recurrent HBV. Larger clinical trials are recommended to compare both short-term and long-term efficacy using entecavir among nucleoside-naïve decompensated chronic HBV patients before and after liver transplantation.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Chronic Disease
  • DNA, Viral / blood
  • DNA, Viral / drug effects
  • Guanine / analogs & derivatives*
  • Guanine / therapeutic use
  • Hepatitis B / complications
  • Hepatitis B / drug therapy*
  • Hepatitis B / surgery
  • Hepatitis B virus / drug effects
  • Humans
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / surgery
  • Liver Transplantation
  • Male
  • Middle Aged


  • Antiviral Agents
  • DNA, Viral
  • entecavir
  • Guanine