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Comparative Trial of Entecavir Versus Adefovir in the Treatment of Chronic Hepatitis B Infection

Randomized, Open-Label, Comparative Study to Evaluate Early Viral Load Reductions and Exploratory Viral Kinetics Following Administration of Entecavir or Adefovir in Nucleoside-Naive Adults With Chronic Hepatitis B Infection

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00096785
Enrollment
69
Registered
2004-11-16
Start date
2004-12-31
Completion date
2008-04-30
Last updated
2010-08-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic Disease, Hepatitis B

Keywords

chronic hepatitis B infection

Brief summary

The purpose of this study is to evaluate antiviral activity and efficacy of entecavir (ETV) compared to adefovir in adults with chronic hepatitis B who have not been treated yet with an antiviral medicine.

Interventions

DRUGentecavir

Tablets, Oral, ETV 0.5 mg, once daily, up to 96 weeks

DRUGadefovir

Tablets, Oral, ADV 10 mg, once daily, up to 96 weeks

Sponsors

Bristol-Myers Squibb
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Chronic hepatitis B treatment naive * Compensated liver disease

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Hepatitis B Virus DNA (HBV DNA) by Polymerase Chain Reaction (PCR) Assay at Week 12Baseline, Week 12Antiviral efficacy, as measured by the mean reduction in serum HBV DNA levels by PCR (log10 copies/mL) at Week 12, adjusted for baseline (Week 12 - baseline). A negative value = improvement.

Secondary

MeasureTime frameDescription
Change From Baseline in HBV DNA by PCR Assay at Week 48Baseline, Week 48Antiviral efficacy, as measured by the mean reduction in serum HBV DNA levels by PCR (log10 copies/mL) at Week 48, adjusted for baseline (Week 48 - Baseline). A negative value = improvement.
Viral Load Undetectable (HBV DNA <300 Copies/mL)Week 48Number of Subjects with HBV DNA \<300 copies/mL by Roche COBAS® Amplicor (limit of quantitation 300 copies/mL)
Alanine Aminotransferase (ALT) NormalizationWeek 48Number of participants with ALT ≤ 1 x upper limit of normal (ULN)
HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Efficacy in Blocking Virus Production and de Novo InfectionsWeek 12The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. The model parameters of interest are the effectiveness of the drug in blocking virus production from infected cells (efficacy, ε) and effectiveness of the study treatment in blocking de novo infection of susceptible cells (η). The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group.
HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Viral Clearance Rate and Infected Cell Death RateWeek 12The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. The model parameters of interest are the clearance rate of the free virus (c), the death rate of productively infected cells (δ), The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group.
HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Half-Life of Free VirusWeek 12The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. An important derived parameter is the half-life of free virus (ie, the average amount of time for HBV particles in plasma to be reduced to half the initial level), calculated as 24\*ln(2)/c. The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group.
HBV DNA Viral Kinetics - Spline ModelWeek 12This analysis uses a 3-parameter piece-wise linear model and describes the biphasic decline in HBV DNA (measured by PCR assay) through Week 12. The 3 parameters are the values for the 2 slopes, describing the first and second phase declines, respectively, and the estimated HBV DNA at the knot (at day 10; the time point where the 2 phases join). The biphasic viral decay kinetics for each treatment were obtained using a spline fitting procedure to estimate the 3 parameters for each subject; these estimates were then averaged within each treatment group.
Summary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and Deathscumulative through the end of on-treatment observation as available at the time of the Week 48 datasetAE=new untoward medical occurrence or worsening of pre-existing medical condition regardless of causal relationship to treatment. SAE=untoward medical occurrence that is life-threatening, a congenital anomaly/birth defect, or an important medical event, or results in death, inpatient hospitalization/prolongation of hospitalization, or persistent/significant disability. AE grades: mild (1), moderate (2), severe (3), life-threatening (4), death (5). ALT flare= \>2x baseline & \>10x ULN up to end of therapy + 5 days. Hepatic SAE=SAEs consistent with worsening of hepatitis or hepatic decompensation.
Summary of Safety - Laboratory Abnormalities Reported as Clinical AEsWeek 48Laboratory abnormalities reported as clinical AEs

Countries

Canada, Hong Kong, Indonesia, Philippines, Singapore, Taiwan, Thailand, United States

Participant flow

Pre-assignment details

132 enrolled; 63 not randomized (59 did not meet study criteria, 3 withdrew consent, 1 lost to follow-up). 1 randomized to adefovir (ADV) received entecavir (ETV) throughout treatment, & is counted in the ADV group for primary efficacy analysis, not included in the secondary efficacy analyses, & counted in the ETV group in safety analyses.

Participants by arm

ArmCount
Entecavir
ETV 0.5 mg once daily (QD)
35
Adefovir
ADV 10 mg QD
34
Total69

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLost to Follow-up10
Overall StudyRelocated10
Overall StudyWithdrawal by Subject01

Baseline characteristics

CharacteristicEntecavirAdefovirTotal
Age Continuous38 participants28 participants31 participants
Alanine Aminotransferease (ALT)109.4 U/L
STANDARD_DEVIATION 81.76
176.4 U/L
STANDARD_DEVIATION 207.22
142.4 U/L
STANDARD_DEVIATION 159.12
Hepatitis B virus DNA (HBV DNA) by Polymerase Chain Reaction (PCR)10.45 log10 copies/mL
STANDARD_DEVIATION 2.125
9.89 log10 copies/mL
STANDARD_DEVIATION 1.201
10.18 log10 copies/mL
STANDARD_DEVIATION 1.742
Prior interferon (IFN)
No prior IFN
34 Participants33 Participants67 Participants
Prior interferon (IFN)
Prior IFN
1 Participants1 Participants2 Participants
Race/Ethnicity, Customized
Asian
31 Participants30 Participants61 Participants
Race/Ethnicity, Customized
Black or African American
3 Participants2 Participants5 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
White
1 Participants1 Participants2 Participants
Region of Enrollment
East Asia
26 participants21 participants47 participants
Region of Enrollment
North America
9 participants13 participants22 participants
Sex: Female, Male
Female
13 Participants11 Participants24 Participants
Sex: Female, Male
Male
22 Participants23 Participants45 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
16 / 3317 / 36
serious
Total, serious adverse events
2 / 331 / 36

Outcome results

Primary

Change From Baseline in Hepatitis B Virus DNA (HBV DNA) by Polymerase Chain Reaction (PCR) Assay at Week 12

Antiviral efficacy, as measured by the mean reduction in serum HBV DNA levels by PCR (log10 copies/mL) at Week 12, adjusted for baseline (Week 12 - baseline). A negative value = improvement.

Time frame: Baseline, Week 12

Population: As-randomized participants who completed 12 weeks of treatment

ArmMeasureValue (MEAN)Dispersion
EntecavirChange From Baseline in Hepatitis B Virus DNA (HBV DNA) by Polymerase Chain Reaction (PCR) Assay at Week 12-6.23 log10 copies/mLStandard Error 0.247
AdefovirChange From Baseline in Hepatitis B Virus DNA (HBV DNA) by Polymerase Chain Reaction (PCR) Assay at Week 12-4.52 log10 copies/mLStandard Error 0.357
Secondary

Alanine Aminotransferase (ALT) Normalization

Number of participants with ALT ≤ 1 x upper limit of normal (ULN)

Time frame: Week 48

Population: treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses.

ArmMeasureValue (NUMBER)
EntecavirAlanine Aminotransferase (ALT) Normalization25 participants
AdefovirAlanine Aminotransferase (ALT) Normalization20 participants
Secondary

Change From Baseline in HBV DNA by PCR Assay at Week 48

Antiviral efficacy, as measured by the mean reduction in serum HBV DNA levels by PCR (log10 copies/mL) at Week 48, adjusted for baseline (Week 48 - Baseline). A negative value = improvement.

Time frame: Baseline, Week 48

Population: Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses.

ArmMeasureValue (MEAN)Dispersion
EntecavirChange From Baseline in HBV DNA by PCR Assay at Week 48-7.28 log10 c/mLStandard Error 0.327
AdefovirChange From Baseline in HBV DNA by PCR Assay at Week 48-5.08 log10 c/mLStandard Error 0.455
Secondary

HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Efficacy in Blocking Virus Production and de Novo Infections

The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. The model parameters of interest are the effectiveness of the drug in blocking virus production from infected cells (efficacy, ε) and effectiveness of the study treatment in blocking de novo infection of susceptible cells (η). The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group.

Time frame: Week 12

Population: Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses.

ArmMeasureGroupValue (NUMBER)
EntecavirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Efficacy in Blocking Virus Production and de Novo InfectionsEffectiveness in blocking de novo infections - η6.07 percent effective
EntecavirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Efficacy in Blocking Virus Production and de Novo InfectionsEfficacy in blocking virus production - ε99.87 percent effective
AdefovirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Efficacy in Blocking Virus Production and de Novo InfectionsEfficacy in blocking virus production - ε99.46 percent effective
AdefovirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Efficacy in Blocking Virus Production and de Novo InfectionsEffectiveness in blocking de novo infections - η5.87 percent effective
Secondary

HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Half-Life of Free Virus

The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. An important derived parameter is the half-life of free virus (ie, the average amount of time for HBV particles in plasma to be reduced to half the initial level), calculated as 24\*ln(2)/c. The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group.

Time frame: Week 12

Population: Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses.

ArmMeasureValue (NUMBER)
EntecavirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Half-Life of Free Virus14.52 hours
AdefovirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Half-Life of Free Virus32.46 hours
Secondary

HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Viral Clearance Rate and Infected Cell Death Rate

The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. The model parameters of interest are the clearance rate of the free virus (c), the death rate of productively infected cells (δ), The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group.

Time frame: Week 12

Population: Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses.

ArmMeasureGroupValue (NUMBER)
EntecavirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Viral Clearance Rate and Infected Cell Death RateInfected cell death - δ0.08 per day
EntecavirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Viral Clearance Rate and Infected Cell Death RateViral Clearance - c1.70 per day
AdefovirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Viral Clearance Rate and Infected Cell Death RateInfected cell death - δ0.04 per day
AdefovirHBV DNA Viral Kinetics Estimates of Exponential Decay Model - Viral Clearance Rate and Infected Cell Death RateViral Clearance - c0.91 per day
Secondary

HBV DNA Viral Kinetics - Spline Model

This analysis uses a 3-parameter piece-wise linear model and describes the biphasic decline in HBV DNA (measured by PCR assay) through Week 12. The 3 parameters are the values for the 2 slopes, describing the first and second phase declines, respectively, and the estimated HBV DNA at the knot (at day 10; the time point where the 2 phases join). The biphasic viral decay kinetics for each treatment were obtained using a spline fitting procedure to estimate the 3 parameters for each subject; these estimates were then averaged within each treatment group.

Time frame: Week 12

Population: Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses.

ArmMeasureGroupValue (NUMBER)
EntecavirHBV DNA Viral Kinetics - Spline ModelSecond slope (second phase of viral decay)-0.034 log10 copies/mL
EntecavirHBV DNA Viral Kinetics - Spline ModelFirst slope (first phase of viral decay)-0.391 log10 copies/mL
AdefovirHBV DNA Viral Kinetics - Spline ModelFirst slope (first phase of viral decay)-0.329 log10 copies/mL
AdefovirHBV DNA Viral Kinetics - Spline ModelSecond slope (second phase of viral decay)-0.024 log10 copies/mL
Secondary

Summary of Safety - Laboratory Abnormalities Reported as Clinical AEs

Laboratory abnormalities reported as clinical AEs

Time frame: Week 48

Population: As-treated population. 1 participant who was randomized to ADV, but treated with ETV was counted in the ETV group.

ArmMeasureGroupValue (NUMBER)
EntecavirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsALT increased1 Participants
EntecavirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsLipase increased1 Participants
EntecavirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsBlood phosphorus decreased0 Participants
EntecavirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsLiver function test abnormal0 Participants
EntecavirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsPlatelet count decreased0 Participants
EntecavirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsProtein urine present0 Participants
AdefovirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsPlatelet count decreased1 Participants
AdefovirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsALT increased2 Participants
AdefovirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsLiver function test abnormal1 Participants
AdefovirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsLipase increased2 Participants
AdefovirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsProtein urine present1 Participants
AdefovirSummary of Safety - Laboratory Abnormalities Reported as Clinical AEsBlood phosphorus decreased1 Participants
Secondary

Summary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and Deaths

AE=new untoward medical occurrence or worsening of pre-existing medical condition regardless of causal relationship to treatment. SAE=untoward medical occurrence that is life-threatening, a congenital anomaly/birth defect, or an important medical event, or results in death, inpatient hospitalization/prolongation of hospitalization, or persistent/significant disability. AE grades: mild (1), moderate (2), severe (3), life-threatening (4), death (5). ALT flare= \>2x baseline & \>10x ULN up to end of therapy + 5 days. Hepatic SAE=SAEs consistent with worsening of hepatitis or hepatic decompensation.

Time frame: cumulative through the end of on-treatment observation as available at the time of the Week 48 dataset

Population: As-treated population. 1 participant was randomized to ADV, but treated with ETV was counted in the ETV group.

ArmMeasureGroupValue (NUMBER)
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsMalignant neoplasm0 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Influenza6 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsDiscontinuation due to AE0 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Nasopharyngitis4 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Any AE28 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Pyrexia4 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsSerious AE1 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Back Pain0 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Headache9 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Grade 3-4 AEs2 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsDeath0 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsALT Flare0 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsHepatic SAE1 Participants
EntecavirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Upper Respiratory Infection8 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsHepatic SAE2 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsALT Flare1 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsDeath0 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsDiscontinuation due to AE1 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsMalignant neoplasm0 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Any AE27 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Headache6 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Upper Respiratory Infection8 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Influenza4 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Nasopharyngitis6 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Pyrexia6 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Back Pain5 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsOn Treatment: Grade 3-4 AEs5 Participants
AdefovirSummary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and DeathsSerious AE3 Participants
Secondary

Viral Load Undetectable (HBV DNA <300 Copies/mL)

Number of Subjects with HBV DNA \<300 copies/mL by Roche COBAS® Amplicor (limit of quantitation 300 copies/mL)

Time frame: Week 48

Population: Treated participants who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses.

ArmMeasureValue (NUMBER)
EntecavirViral Load Undetectable (HBV DNA <300 Copies/mL)19 Participants
AdefovirViral Load Undetectable (HBV DNA <300 Copies/mL)6 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026