Abstract
<title>Abstract</title> <p>Background Chronic hepatitis B (CHB) requires long-term antiviral therapy to prevent disease progression. This study evaluated the long-term efficacy and safety of entecavir (ETV) therapy and investigated predictors of partial virological response (PVR) in treatment-naive CHB patients. Methods This retrospective study included 230 nucleoside-naive CHB patients treated with entecavir between January 2020 and December 2024. Virological response (VR) was defined as HBV-DNA < 20 IU/mL. PVR was defined as a > 1 log10 IU/mL reduction in HBV-DNA despite detectable viral DNA after at least 12 months of therapy. Clinical, biochemical, and virological parameters were analyzed during follow-up. Results The mean age was 44 ± 18 years, and 54.7% were male. Baseline HBV-DNA was 6.8 log10 IU/mL. VR rates reached 66% at month 3, 86% at month 6, 89% at year 1, and 100% by years 4–5. ALT normalization improved progressively, while HBeAg seroconversion was highest during years 2–3. PVR occurred in 10.2% of patients. PVR was significantly associated with higher baseline HBV-DNA levels and failure to achieve virological response VR at week 24. No serious adverse events were observed. Conclusions ETV therapy provides effective, durable viral suppression and excellent safety in treatment-naive CHB patients. Continued treatment in patients with PVR may still achieve complete virological suppression.</p>