Efficacy of long-term tenofovir-based rescue therapy in patients with chronic hepatitis B refractory to nucleoside/nucleotide analogs
| Autor: | Yoshiyuki Suzuki, Masahiro Kobayashi, Norio Akuta, Fumitaka Suzuki, Shunichiro Fujiyama, Tetsuya Hosaka, Yusuke Kawamura, Hitomi Sezaki, Yukiko Suzuki, Hiromitsu Kumada, Mariko Kobayashi, Kenji Ikeda, Yasuji Arase, Rie Mineta, Satoshi Saitoh |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine Hepatitis B virus medicine.medical_specialty Genotype Combination therapy Administration Oral medicine.disease_cause Antiviral Agents Gastroenterology Drug Administration Schedule 03 medical and health sciences Hepatitis B Chronic 0302 clinical medicine Internal medicine Drug Resistance Viral medicine Adefovir Humans Hepatitis B e Antigens Tenofovir Aged Retrospective Studies Hepatitis B Surface Antigens business.industry virus diseases Lamivudine Entecavir Middle Aged Viral Load Hepatology Viral Breakthrough Regimen Treatment Outcome 030104 developmental biology DNA Viral Drug Therapy Combination Female 030211 gastroenterology & hepatology business Biomarkers medicine.drug |
| Zdroj: | Journal of Gastroenterology. 52:641-651 |
| ISSN: | 1435-5922 0944-1174 |
| DOI: | 10.1007/s00535-016-1270-5 |
| Popis: | Few studies have investigated the efficacy of long-term tenofovir disoproxil fumarate (TDF)-based rescue therapy in patients with chronic hepatitis B refractory to nucleoside/nucleotide analogs. We retrospectively analyzed 40 Japanese patients with chronic hepatitis B refractory to nucleoside/nucleotide analogs who received TDF-based rescue therapy [TDF monotherapy, TDF plus lamivudine (LAM) combination therapy, or TDF plus entecavir (ETV) combination therapy] followed up for a median of 45 months (range 14–99 months). Viral response, changes in hepatitis B surface antigen levels from the baseline, and viral breakthrough during therapy were analyzed. The proportion of patients with undetectable serum hepatitis B virus (HBV) DNA levels (less than 2.1 log copies per milliliter) (viral response) during TDF-based rescue therapy was 68, 78, 85, 88, 83, 81, 88, and 100 % at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, and 4 years respectively. There were no differences in the viral response rate between the TDF plus LAM group and the TDF plus ETV group. The mean reduction from the baseline in hepatitis B surface antigen levels in patients with LAM-resistant HBV was greater than the reductions in patients with adefovir dipivoxil (ADV)-resistant or ETV-resistant HBV at 2 and 3 years (P = 0.024, and P = 0.025 respectively). However, two patients with ADV- or ETV-resistant HBV at the baseline developed viral breakthrough during TDF-based rescue therapy. Long-term therapy with a TDF-based rescue regimen demonstrated high viral suppression in patients in whom LAM plus ADV combination therapy, ETV plus ADV combination therapy, or ETV monotherapy had failed. However, patients with ADV- or ETV-resistant HBV at the baseline may develop viral breakthrough and resistance, and careful follow-up is advised. |
| Databáze: | OpenAIRE |
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