Non-Saccharomyces Yeasts from Organic Vineyards as Spontaneous Fermentation Agents.

Currently, non-Saccharomyces yeasts are the subject of interest, among other things, for their contribution to the aromatic complexity of wines. In this study, the characterisation of non-Saccharomyces yeasts was addressed by their isolation during spontaneous fermentations of organic Verdejo grapes, obtaining a total of 484 isolates, of which 11% were identified by molecular techniques as non-Saccharomyces yeasts. Fermentative isolates belonging to the species Hanseniaspora meyeri, Hanseniaspora osmophila, Pichia guilliermondii, Pichia kudriavzevii, Torulaspora delbrueckii, and Wickerhamomyces anomalus were analysed. Significant differences were found in the yeast populations established at the different fermentation stages. Interestingly, W. anomalus stood up as a widely distributed species in vineyards, vintages, and fermentation stages. Several of the strains studied stood out for their biotechnological potential in the production of Verdejo wine, showing the presence of relevant enzymatic activity for the release of varietal aromas and the technological improvement of the winemaking process. Three enzymatic activities were found in an important number of isolates, ß-glucosidase, protease, and ß-lyase, implicated in the positive aromatic impact on this style of white wine. In that sense, all the isolates of W. anomalus presented those activities. T. delbrueckii isolates were highlighted for their significant ß-lyase activity. In addition, T. delbrueckii was outlined because of its potential to achieve an elevated fermenting power, as well as the lack of lag phase. The results obtained highlight the importance of maintaining the microbial diversity that contributes to the production of wines with unique and distinctive characteristics of the production region.

Entrapment of Glucose Oxidase and Catalase in Silica-Calcium-Alginate Hydrogel Reduces the Release of Gluconic Acid in Must.

Glucose oxidase (GOX) and catalase (CAT) were co-immobilized in silica-calcium-alginate hydrogels to degrade must glucose. The effect of the enzyme dose (1.2-2.4 U/mL), the initial must pH (3.6-4.0), and the incubation temperature (10-20 °C) on the glucose consumption, gluconic acid concentration, pH, and color intensity of Verdejo must was studied by using a Box-Behnken experimental design and comparing free and co-immobilized enzymes. A reduction of up to 37.3 g/L of glucose was observed in co-immobilized enzyme-treated must, corresponding to a decrease in its potential alcohol strength of 2.0% vol. (v/v), while achieving a slight decrease in its pH (between 0.28 and 0.60). This slight acidification was due to a significant reduction in the estimated gluconic acid found in the must (up to 73.7%), likely due to its accumulation inside the capsules. Regarding the operational stability of immobilized enzymes, a gradual reduction in glucose consumption was observed over eight consecutive cycles. Finally, co-immobilized enzymes showed enhanced efficiency over a reaction period of 48 h, with an 87.1% higher ratio of glucose consumed per enzyme dose in the second 24 h period compared with free enzymes. These findings provide valuable insights into the performance of GOX-CAT co-immobilized to produce reduced-alcohol wines, mitigating excessive must acidification.

Silica-Calcium-Alginate Hydrogels for the Co-Immobilization of Glucose Oxidase and Catalase to Reduce the Glucose in Grape Must.

Higher temperatures due to climate change are causing greater sugar production in grapes and more alcoholic wines. The use of glucose oxidase (GOX) and catalase (CAT) in grape must is a biotechnological green strategy to produce reduced-alcohol wines. GOX and CAT were effectively co-immobilized by sol-gel entrapment in silica-calcium-alginate hydrogel capsules. The optimal co-immobilization conditions were achieved at a concentration of the colloidal silica, sodium silicate and sodium alginate of 7.38%, 0.49% and 1.51%, respectively, at pH 6.57. The formation of a porous silica-calcium-alginate structure was confirmed by environmental scanning electron microscopy and the elemental analysis of the hydrogel by X-ray spectroscopy. The immobilized GOX showed a Michaelis-Menten kinetic, while the immobilized CAT fits better to an allosteric model. Immobilization also conferred superior GOX activity at low pH and temperature. The capsules showed a good operational stability, as they could be reused for at least 8 cycles. A substantial reduction of 26.3 g/L of glucose was achieved with encapsulated enzymes, which corresponds to a decrease in potential alcoholic strength of must of about 1.5% vol. These results show that co-immobilized GOX and CAT in silica-calcium-alginate hydrogels is a promising strategy to produce reduced-alcohol wines.

Selective Wine Aroma Enhancement through Enzyme Hydrolysis of Glycosidic Precursors.

Selective enhancement of wine aroma was achieved using a broad spectrum of exogenous glycosidases. Eight different enzyme preparations were added to Verdejo wine, resulting in an increase in the levels of varietal volatile compounds compared to the control wine after 15 days of treatment. The enzyme preparations studied were robust under winemaking conditions (sulfur dioxide, reducing sugars, and alcohol content), and no inhibition of ß-glucosidase activity was observed. Significant differences were detected in four individual terpenes (α-terpineol, terpinen-4-ol, α-pinene, and citronellal) and benzyl alcohol in all the treated wines compared to the control wine, contributing to the final wine to varying degrees. In addition, a significant increase in the other aromatic compounds was observed, which showed different patterns depending on the enzyme preparation that was tested. The principal component analysis of the data revealed the possibility of modulating the different aromatic profiles of the final wines depending on the enzyme preparation used. Taking these results into account, enhancement of the floral, balsamic, and/or fruity notes of wines is possible by using a suitable commercial enzyme preparation.

Screening and Enzymatic Evaluation of Saccharomyces cerevisiae Populations from Spontaneous Fermentation of Organic Verdejo Wines.

Microbial populations in spontaneous winemaking contribute to the distinctiveness and quality of the wines. In this study, molecular methods were applied to 484 isolated yeasts to survey the diversity of the Saccharomyces cerevisiae population in spontaneous fermentations of organic Verdejo grapes. Identification was carried out at strain level for samples from different vineyards correct.and stages of the winemaking process over the course of two vintages, establishing 54 different strains. The number of isolates belonging to each strain was not homogeneous, as two predominant strains represented more than half of the isolates independent of vineyard or vintage. Regarding the richness and abundance, differences among the stages of fermentation were confirmed, finding the highest diversity values in racked must and in the end of fermentation stages. Dissimilarity in S. cerevisiae communities was found among vineyards and vintages, distinguishing representative groups of isolates for each of the populations analysed. These results highlight the effect of vineyard and vintage on yeast communities as well as the presence of singular strains in populations of yeasts. Oenologically relevant enzymatic activities, ß-lyase, protease and ß-glucanase, were detected in 83.9%, 96.8% and 38.7% of the isolates, respectively, which may be of interest for potential future studies.

Measures of accommodative function in secondary school year 9 and year 13: a 4-year longitudinal study.

PURPOSE: To characterize accommodative function in secondary school children in year 9 and year 13 and assess the possible relationship between daily working conditions (number of near work hours and distances) and accommodation variables related to accommodative excess. METHODS: This was a prospective study. Participants were 43 subjects who were first examined in year 9 and then again when they were in year 13. The accommodation variables measured in each session were as follows: accommodation amplitude (AA), accommodative response (AR), monocular and binocular accommodation flexibility (MAF and BAF), negative relative accommodation (NRA), and positive relative accommodation (PRA). Other data recorded were the number of hours spent working at near vision tasks and the distances used for these tasks. Participants were classified as those with accommodation variables within the normal range (NA) and those with variables suggesting accommodative excess (AE). RESULTS: Several accommodative function variables were below normative values in both year 9 and year 13. The number of subjects classified as having AE went from 27.9% in year 9 to 58.1% in year 13 according to AR (p < 0.005) and from 23.3 to 46.5% according to MAF (p = 0.024). More near work was reported in year 13 (44.6 h/week) than year 9 (32.7 h/week) (p < 0.001). It emerged that subjects in year 13 spent more hours working at near if they had AE than if they were assigned to the NA group. No differences were detected in near work distances used by subjects in the NA and AE groups in both years. CONCLUSIONS: In both school years, values outside the norm were detected in several accommodative function measures. Also, devoting more hours to near work was linked to a greater extent of accommodative excess. We would therefore recommend regular accommodative function assessment in secondary school children.

Membrane Dialysis for Partial Dealcoholization of White Wines.

Membrane dialysis is studied as a promising technique for partial dealcoholization of white wines. The performance of three membrane processes applied for the partial dealcoholization of white wines of the Verdejo variety has been studied in the present work. Combination of Nanofiltration with Pervaporation, single step Pervaporation and, finally, Dialysis, have been applied to white wines from same variety and different vintages. The resulting wines have been chemically and sensorially analyzed and results have been compared with initial characteristics of the wines. From the results obtained, we can conclude that all procedures lead to significant alcohol content reduction (2%, 0.9% and 1.23% v/v respectively). Nevertheless, the best procedure consists in the application of Dialysis to the wines which resulted in a reasonable alcohol content reduction while maintaining organoleptic properties (only 14 consumers were able to distinguish the filtered and original wines, with 17 consumers needed to be this differences significant) and consumer acceptability of the original wine. Therefore, membrane dialysis, as a method of partial dealcoholization of white wines, has undoubted advantages over other techniques based on membranes, which must be confirmed in subsequent studies under more industrial conditions. This work represents the first application of Dialysis for the reduction of alcohol content in wines.

Volatile composition and sensory properties of wines from vineyards affected by iron chlorosis.

Recent studies have shown that mild to moderate iron chlorosis can have positive effects on grape quality potential, including volatile profile. The main objective of this work was to investigate, for the first time, how moderate iron stress in grapevines affects the presence of volatile organic compounds (VOCs) in wines. The study was carried out during 2018-2019 seasons, in 20 Tempranillo vineyard subzones with different degree of iron deficiency, located in Ribera del Duero (North-Central Spain). The results showed that moderate iron stress increased in wines the concentrations of VOCs associated with floral notes, such as 2-phenylacetaldehyde, 2-phenylethanol and 2-phenylethyl acetate, while reducing the presence of C6-alcohols, responsible for green-herbaceous aroma. A favourable reduction of pH and a betterment of parameters related to colour were detected in wines from iron deficient subzones. Chlorosis incidence was associated to improvements in wine sensory attributes as layer intensity, black fruit and aroma intensity.

Autobiographical Memory, Gratitude, Forgiveness and Sense of Humor: An Intervention in Older Adults.

Research has shown that happiness and well-being play a fundamental role in the health of older adults. For this reason, programs based on Positive Psychology seek to improve quality of life, preventing and reducing the appearance of emotional disorders. The objective of this study was to verify whether an intervention based on Autobiographical Memory, Forgiveness, Gratitude, and Sense of humor would increase quality of life in institutionalized older adults. We used a quasi-experimental design with pre- and post-intervention measures and follow-on measures at 3, 6, and 12 months. A total of 111 institutionalized older adults participated in the study and were randomly assigned to one of three groups: experimental (n = 36), placebo (n = 39), and control (n = 36). Measurements were taken of depression, subjective happiness, satisfaction with life, psychological well-being, and specific memories. Program duration was 11 weeks, followed by refresher sessions of the activities that had been conducted. The results showed that the intervention was effective, producing lasting increase in the participating adults' well-being, maintained for the following 12 months, in contrast to the other two groups. In conclusion, the proposed intervention proved to be a novel tool that was effective, easily applied, and able to improve quality of life and emotional disorders in older adults.

Relationships between chlorophyll content of vine leaves, predawn leaf water potential at veraison, and chemical and sensory attributes of wine.

BACKGROUND: Water deficit and iron deficiency (iron chlorosis) are common environmental stresses that affect grapevine production in the Mediterranean area. Studies on the impact of both stresses, when they act simultaneously, are rare. The main objective of this investigation was to evaluate the combined effects of the incidence of iron chlorosis and the vine water status on quality of Tempranillo wine. For this, 20 non-irrigated vineyard subzones (10 m × 10 m each), from non-affected to moderately affected by iron chlorosis, were monitored in the Ribera del Duero area (north-central Spain) during two consecutive seasons. RESULTS: Factorial analyses of variance were performed to study the effects of predawn leaf water potential and foliar chlorophyll content, both measured at veraison, on chemical and sensory characteristics of wine. With an impact much greater than water status, the incidence of iron stress decreased pH of the wine and enhanced sensory attributes as tonality, layer intensity, flavour intensity, and persistence in the mouth. There were increases in red colour, astringency, and persistence of the wine associated with chlorosis, although they might be restricted in water-deficit conditions. CONCLUSION: The results have demonstrated that mild to moderate iron stress can have positive effects on chemical and sensory attributes of Tempranillo wine. Measurements of foliar chlorophyll content at veraison could be very useful to map quality potential in rainfed vineyards affected by iron deficiency. © 2020 Society of Chemical Industry.

Evaluating the influence of simultaneous inoculation of SiO2-alginate encapsulated bacteria and yeasts on volatiles, amino acids, biogenic amines and sensory profile of red wine with lysozyme addition.

The influence of the timing of inoculation (sequential and simultaneous alcoholic fermentation (AF)/malolactic fermentation (MLF)) on the chemical and sensory properties of red wines was studied. The impact of the encapsulation of Oenococcus oeni into SiO2-alginate hydrogel (Si-ALG) and the addition of lysozyme in wines inoculated with encapsulated bacteria were also analysed. There was a significant influence of the timing of inoculation on the volatile composition of the wines just as on the amino acid and biogenic amine content. The wines produced by simultaneous AF/MLF showed the highest contents of some volatile compounds, such as ethyl esters and terpenes, as well as amino acids and tyramine. Bacterial encapsulation affected the volatile and amino acid profile of the wines, while the biogenic amine composition was not modified. The chemical composition of the wines was not altered by the presence of lysozyme. A trained panel did not perceive substantial differences between treatments.

Abiotic stress management and Verdejo wine composition: cluster thinning in different water regimes.

BACKGROUND: The effects of cluster thinning (TH) on Verdejo wine composition were studied. Cluster thinning was applied in three water regimes (WR) (R0, rainfed control; R25, drip-irrigated at 25% ETo, and R50, drip-irrigated at 50% ETo) during the 2012-2014 seasons. RESULTS: Cluster thinning advanced grape maturity, although this was only significant in 2012. A significant effect of TH on R0 was observed in 2013, the wettest season, increasing the concentration of alcohols, esters, acetates, and lactones. The same trend was shown in 2012 for all groups of volatile compounds in R0. In contrast, for all volatile families to increase was observed in 2014, the driest season, when TH was applied to R50. WR*TH interactions were found in most wine chemical parameters. CONCLUSION: The variation in wine volatile composition among the vintages that were observed shows that the capacity of TH to exert an influence depends not only on the water regime but also on annual conditions. © 2019 Society of Chemical Industry.

Strengths in older adults: differential effect of savoring, gratitude and optimism on well-being.

Objetive: The present study aimed to compare the efficacy of three separate strengths training-based interventions - Gratitude, Savoring, and Optimism - in older adults. Method: The sample comprised 124 older adults, namely, 74 women and 50 men, non-institutionalized individuals who regularly attend day centers in the provinces of Jaén and Córdoba, southern Spain. Their ages ranged between 60 and 89 years. The measures used were Anxiety, Depression, Life Satisfaction, Positive and Negative Affect, Subjective Happiness, and Resilience. Results: Training in Gratitude and Savoring increased scores in Life Satisfaction, Positive Affect, Subjective Happiness and Resilience, and reduced Negative Affect, whereas training in Optimism failed to produce a significant change in these variables. The Savoring and Optimism interventions decreased scores in Depression but, contrary to hypothesis, this was not the case for Gratitude. Conclusion: These results represent an important step in understanding what type of strengths work best when it comes to enhancing well-being in older adults and consequently helping them tackle the challenges of everyday life and recover as quickly as possible from the adverse situations and events that may arise.

Effect of stressful malolactic fermentation conditions on the operational and chemical stability of silica-alginate encapsulated Oenococcus oeni.

Oenococcus oeni was encapsulated into inter-penetrated polymer networks of silica-alginate (SiO2-ALG). Fourier transform infrared spectroscopy analysis proved the presence and the polycondensation of the siliceous material used in SiO2-ALG capsules. Environmental scanning electron microscopy showed that the structure of SiO2-ALG biocapsules was rougher than in alginate (ALG) biocapsules. The behaviour of SiO2-ALG biocapsules was evaluated at pH 3.0-3.6 and alcohol degrees of 12-15%. Repeated-batch malolactic fermentations (MLF) demonstrated that SiO2-ALG biocapsules can be reused efficiently for five times in either low-pH or high-ethanol wines, while free bacteria only can be used once under the most favourable MLF conditions. The inclusion of siliceous materials into ALG hydrogel improved the stability of the biocapsules, reducing their shrinking and achieving an excellent integrity under winemaking conditions. These results proved the possibility of industrial application of SiO2-ALG biocapsules in winemaking.

Predictors of primary non-adherence to concomitant chronic treatment in HIV-infected patients with antiretroviral therapy.

OBJECTIVES: To identify the independent risk factors of primary non-adherence to chronic concomitant treatment in HIV-positive patients, and to measure primary and secondary non-adherence rates to chronic treatments, and secondary non-adherence to antiretroviral therapy and the prevalence of concomitant chronic diseases. METHODS: We conducted a retrospective study that included HIV-infected patients with antiretroviral treatmentwho attended the pharmaceutical care office between January and December 2012. The dependent variable was primary non-adherence to concomitant prescription drugs for chronic diseases. To know the predictors of concomitant primary non-adherence, we performed a univariate analysis and a multivariate binary logistic regression model to identify the independent predictors of primary non-adherence to co-medication. RESULTS: Out of 598 patients analysed, 333 patients had a new co-medication prescribed during the studied period. The number of comorbidities per patient was 2.3 and the patients were treated with an average of 3.4 drugs. The rates of primary and secondary non-adherence to co-medication were 8.4% and 44.4%, respectively. The co-occurrence of primary and secondary non-adherence was 24.9%. The number of comorbidities (p=0.001) and co-medications (p=0.001) was significantly higher in patients who had primary non-adherence to co-medication. Furthermore, there was a statistically significant relationship between primary non-adherence and patients treated with psychotropic drugs (p=0.03). The multivariate analysis showed the independent predictor of primary non-adherence to co-medication was the number of co-medications (p<0.001). CONCLUSION: One-third of new concomitant medications prescribed to HIV-positive patients were never filled from the pharmacy. The number of co-medications was identified as a predictor of primary non-adherence to chronic concomitant treatment in HIV-infected population.

Highly Efficient Malolactic Fermentation of Red Wine Using Encapsulated Bacteria in a Robust Biocomposite of Silica-Alginate.

Bacteria encapsulation to develop malolactic fermentation emerges as a biotechnological strategy that provides significant advantages over the use of free cells. Two encapsulation methods have been proposed embedding Oenococcus oeni, (i) interpenetrated polymer networks of silica and Ca-alginate and (ii) Ca-alginate capsules coated with hydrolyzed 3-aminopropyltriethoxysilane (hAPTES). On the basis of our results, only the first method was suitable for bacteria encapsulation. The optimized silica-alginate capsules exhibited a negligible bacteria release and an increase of 328% and 65% in L-malic acid consumption and mechanical robustness, respectively, compared to untreated alginate capsules. Moreover, studies of capsule stability at different pH and ethanol concentrations in water solutions and in wine indicated a better behavior of silica-alginate capsules than untreated ones. The inclusion of silicates and colloidal silica in alginate capsules containing O. oeni improved markedly their capacity to deplete the levels of L-malic acid in red wines and their mechanical robustness and stability.

Research progress in coating techniques of alginate gel polymer for cell encapsulation.

Cell encapsulation is used as a biotechnology tool to solve the technological problems derived from handling and application of cells in a great range of fields. This involves immobilization of the cells within a polymeric gel that permits the preservation of their metabolic activity. Alginate is widely established as the most suitable polymer for cell encapsulation. However, alginate gel capsules suffer several disadvantages because of their lack of mechanical and chemical stability. This review summarizes results of recent advances in coating techniques that include ionic and covalent cross-linking between alginate and coating materials for cell encapsulation as a strategy to solve the disadvantages mentioned before. Throughout this review, physicochemical properties of coated-alginate capsules and the effect of coating process on metabolic activity and viability of immobilized cells have been specially discussed.

Granulocyte-Monocyte Apheresis as an Adjuvant Therapy to Anti-Tumor Necrosis Factor Drugs for Ulcerative Colitis.

Biologic anti-tumor necrosis factor (TNF) drugs have demonstrated their efficacy for the treatment of ulcerative colitis. Nevertheless, some patients will not respond to this therapy or will develop loss of response. Leukapheresis is the main non-pharmacological therapy for some immune-mediated diseases. The aim of our study was to describe our experience with this therapy in ulcerative colitis patients after loss of response to anti-TNF treatment. Leukapheresis was indicated in four patients with left-sided or extensive colitis because of partial response to biological therapy or secondary loss of response to it. All patients received 8 to 10 sessions in an intensive regimen. Globally, a decrease in the Mayo score was observed. The overall response rate was 50% with one patient who displayed sustained response. No patients have required colectomy during follow-up. Adjuvant treatment with leukapheresis in patients with inadequate response to anti-TNF treatment showed some beneficial effect, although of limited duration, in patients with ulcerative colitis.

Validación española de la Escala de Observación Enfermera de la Intensidad Sintomática en unidades de hospitalización psiquiátrica (NOIIS) / Spanish validation of the Nursing Observed Illness Intensity Scale in psychiatric units

Introducción. La revisión de la investigación existente evidencia las deficiencias en la oferta de instrumentos útiles para controlar el estado de pacientes psiquiátricos institucionalizados. Sin embargo, la escala Nursing Observation Illness Intensity Scale (NOIIS) en inglés ha demostrado evaluar de manera objetiva y rápida el estado de los pacientes en unidades de hospitalización psiquiátrica. En este contexto, nuestro principal objetivo es demostrar la utilidad, así como la fiabilidad y la validez, de la escala NOIIS en español. Método. Tras la traducción y retrotraducción de la escala NOIIS, esta se administró a una muestra de 34 pacientes. Para evaluar la fiabilidad, la escala fue administrada por 2 profesionales, y para controlar su validez se recogieron datos de otras escalas psicopatológicas (BPRS, la escala de dimensiones psicopatológicas DSM-5, la escala ICG y la escala de funcionamiento social SIX). Resultados. El coeficiente alpha de Cronbach mostró valores superiores a 0,89 por ítem, y una fiabilidad del 98% para la puntuación total de la escala. La correlación de Pearson entre la NOIIS y la escala BPRS fue de 70% (p = 0,00). Además, se observó una correlación negativa entre la NOIIS y la SIX. Con la ICG y la escala de dimensiones psicopatológicas DSM-5 también se encontró correlación, aunque inferior a la BPRS. Conclusión. A pesar de que la muestra fue pequeña, los resultados muestran que la versión en español de la NOIIS es aplicable en el medio hospitalario. Asimismo, se demuestra la fiabilidad entre jueces y la validez con respecto a otras escalas de uso en enfermería en salud mental (AU)

Introduction. The reviews of recent literature reveal that there is no really useful scale to monitor patient condition. However, the English version of the Nursing Observed Illness Intensity Scale (NOIIS) has demonstrated to be an objective and quick evaluation of patient status in psychiatric inpatients units. In this context, our aim is demonstrate the usefulness, reliability, and validity of Spanish version of the NOIIS in mental health units. Methods. After the translation and re-translation of NOIIS, 34 patients completed it. To evaluate the reliability, the scale was administered by two professionals. To control the validity data were obtained from other psycho-pathological scales (BPRS, pathological dimensional scale DSM-5, ICG scale, and the social functioning scale SIX). Results. The Cronbach Alpha reliability showed higher values of 0.89 by item, and 98% for total scored. We found a 70% Pearson correlation between NOIIS and BPRS (P = .00), and to a lesser extent between NOIIS and ICG and with the DSM-5 pathological dimensional scale. In addition, we observed a negative correlation between the NOIIS and SIX scale. Conclusion. Even though our sample was small, the results show that the Spanish version of the NOIIS is applicable in the hospital setting. Furthermore, it has also demonstrated its reliability between raters, and the validity compared to other scales used in mental health (AU)

Persistence profile to nucleos(t)ide analogue treatment for patients with chronic hepatitis B.

BACKGROUND: There are currently five approved nucleos(t)ide analogues (NUCs) for the management of chronic hepatitis B (CHB): lamivudine, adefovir dipivoxil, telbivudine, entecavir, and tenofovir disoproxil fumarate. OBJECTIVE: To determine the persistence rates among patients receiving NUCs for CHB at weeks 48, 96 and 144, compare them in these periods, and analyse the evolution of treatment persistence. METHODS: We conducted a retrospective study that included patients with CHB who initiated antiviral therapy and were attended to by the pharmaceutical care office between January 2002 and December 2011. Patients included in a clinical trial or patients who did not collect their medication personally were excluded. There were two different analyses: a comparative analysis of the persistence rates in three periods (weeks 1-48, weeks 48-96, and weeks 96-144); and a Kaplan-Meier analysis to evaluate the evolution of persistence. RESULTS: A total of 102 patients were included. Persistence rates were different in the three periods. They decreased during the course of the different periods, and the decline was more rapid between the first and second period. There were statistically significant differences in the non-persistence of the five drugs (p<0.005). Entecavir had the best profile of persistence, followed by tenofovir. CONCLUSIONS: This study showed that high genetic barrier drugs had a better profile of persistence in the initial treatment of patients with CHB. Data seem to suggest entecavir may offer better persistence rates than tenofovir, and the persistence rates for all five medications dropped in weeks 48-96.