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.

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Keywords Beliefs about medicine, Compliance, Hepatitis B virus, Real-time medication monitoring
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Journal Digestive and Liver Disease
van Vlerken, L.G, Arends, P, Lieveld, F.I, Arends, J.E, Brouwer, W.P, Siersema, P.D, … van Erpecum, K.J. (2015). Real life adherence of chronic hepatitis B patients to entecavir treatment. Digestive and Liver Disease, 47(7), 577–583. doi:10.1016/j.dld.2015.03.024