Current Clinical Applications of Entecavir in Hepatitis B Viruses Infection

Entecavir (ETV) is a guanosine nucleoside analogue widely used in the management of chronic Hepatitis B Virus (HBV) infection. It demonstrates consistent antiviral activity, favourable tolerability, and a high genetic barrier to resistance, making it a reliable option across diverse clinical settings. Evidence from clinical trials and real-world studies confirms that ETV achieves sustained viral suppression, alanine aminotransferase (ALT) normalization, and histological improvement, contributing to reduced long-term risks of cirrhosis and hepatocellular carcinoma. Its pharmacokinetic properties and antiviral effectiveness have been established in both treatment-naïve and lamivudine-resistant patients. ETV maintains clinical utility in various special populations, including individuals with decompensated cirrhosis, chronic kidney disease, post-transplant status, and those receiving immunosuppressive therapy. In these groups, ETV retains efficacy with limited drug-drug interactions and a generally mild adverse-event profile. Optimal adherence to therapy remains essential to ensure sustained viral suppression and minimize the risk of treatment failure. In addition to established clinical roles, emerging research has explored new formulations and potential therapeutic applications of ETV, including long-acting delivery strategies and its possible relevance in oncologic contexts. These developments highlight continued interest in optimizing the use of ETV in HBV management. Overall, ETV remains a well-supported antiviral agent that combines durable efficacy, safety, and broad applicability in the treatment of chronic HBV infection.