Entecavir monotherapy has now been evaluated in patients with hepatitis
B virus (HBV)-related decompensated cirrhosis. Entecavir achieves 1-year
HBV DNA undetectability rates in up to 90% of treatment-naive patients
in this setting without any case of resistance. Entecavir was generally
safe and well tolerated. Lactic acidosis was described almost
exclusively in very advanced liver disease (MELD score > 20) and usually
subsided with drug discontinuation. After 1 year of entecavir therapy,
the Child-Pugh score improved by >= 2 points in up to 50% of patients
and decreased mean MELD score by > 2 points. The 1-year survival rates
were 84-91%, mainly associated with baseline Child-Pugh or MELD scores.
In conclusion, entecavir monotherapy is an excellent treatment option
for treatment-naive patients with HBV-related decompensated cirrhosis
