A Rare Side Effect of Entecavir: Hepatomegaly and Steatosis

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Hepatomegaly and steatosis are rare but potentially fatal side-effects of nucleoside analogues. Here, we present the case of development of hepatomegaly and steatosis in a 53-year-old male who had been treated with entecavir for five years. There were no symptoms of lactic acidosis. At three months after changing entecavir to tenofovir, the liver size returned to normal and maintained within the normal range during the 3-year follow-up. Therefore, it can be presumed that the hepatomegaly and steatosis were due to entecavir therapy. There are very few reports of hepatomegaly and steatosis caused by nucleoside analogues and the majority of the reported cases were associated with lactic acidosis. To the best of our knowledge, there are no previously reported cases of hepatomegaly and steatosis due to entecavir therapy without evidence of lactic acidosis. The aim of this clinical report was to point out a rare side-effect of entecavir and to share our treatment approach.