Viral replication is now recognized as the key driver
of liver injury and disease progression, so the primary
aim of treatment for chronic HBV infection is long-
term suppression of HBV replication to undetectable
levels.1,28,29 Entecavir is a potent HBV antiviral that,
in comparison with lamivudine or adefovir in nucleo-
side-naive patients, has led to superior virological, his-
tological, and biochemical outcomes after 48 weeks of
therapy.21,22,30 In a study of nucleoside-naive Japanese
patients, 3 years of entecavir therapy resulted in potent
virological suppression and additional improvements in
necroinflammatory and fibrosis scores in comparison
with the baseline and week 48 values.31 Virological sup-
pression increased with 5 years of entecavir treatment in
long-term rollover studies, and there was minimal emer-
gence of resistance.32-34 The aim of the present evalua-
tion was to determine whether long-term treatment
with entecavir is associated with continued histological
improvement and reversal of fibrosis or cirrhosis.