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Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment

BACKGROUND: Tenofovir (TDF) is considered as the first line therapy for chronic hepatitis B. This study presents the results of TDF monotherapy in patients who failed previous nucleoside analogue treatment. METHODS: The study included 29 patients treated with TDF 245 mg once daily for 18 months afte...

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Autores principales: Kozielewicz, Dorota, Halota, Waldemar, Wietlicka-Piszcz, Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer India 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4778152/
https://www.ncbi.nlm.nih.gov/pubmed/26612013
http://dx.doi.org/10.1007/s12072-015-9681-6
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author Kozielewicz, Dorota
Halota, Waldemar
Wietlicka-Piszcz, Magdalena
author_facet Kozielewicz, Dorota
Halota, Waldemar
Wietlicka-Piszcz, Magdalena
author_sort Kozielewicz, Dorota
collection PubMed
description BACKGROUND: Tenofovir (TDF) is considered as the first line therapy for chronic hepatitis B. This study presents the results of TDF monotherapy in patients who failed previous nucleoside analogue treatment. METHODS: The study included 29 patients treated with TDF 245 mg once daily for 18 months after lamivudine monotherapy (LAM arm: n = 15) or sequential therapy with lamivudine and entecavir (LAM → ETV arm: n = 14). The previous antiviral therapy was discontinued due to lack of efficacy. All patients had HBV DNA between 2.1 and 8.23 log(10) IU/ml and 15 were HBeAg-positive, while 45 % of patients had increased ALT activity. Undetectable HBV DNA (<20 IU/ml) at months 3, 6, 12 and 18 was the primary endpoint in the study, while HBeAg/HBsAg loss/seroconversion and ALT normalisation were secondary endpoints. RESULTS: Primary nonresponse to TDF was not observed. HBV DNA was undetectable in 80, 80, 80 and 93 % in LAM arm and 50, 71, 86 and 86 % in LAM → ETV arm patients, at 3, 6, 12 and 18 months of TDF therapy, respectively. One patient achieved anti-HBeAg seroconversion. 86.5 % of patients had normal ALT activity at the end of the study. The baseline HBV DNA load, HBeAg status and the length of the duration of TDF therapy appeared significantly associated with the response to the therapy. HBV DNA clearance occurred faster in HBeAg-negative patients than in those positive for HBeAg. CONCLUSIONS: TDF is an effective antiviral medication in patients with previous exposure to LAM or LAM and ETV. Final proportion of patients who achieved undetectable HBV DNA and had normal ALT activity in both arms, was similar.
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spelling pubmed-47781522016-03-22 Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment Kozielewicz, Dorota Halota, Waldemar Wietlicka-Piszcz, Magdalena Hepatol Int Original Article BACKGROUND: Tenofovir (TDF) is considered as the first line therapy for chronic hepatitis B. This study presents the results of TDF monotherapy in patients who failed previous nucleoside analogue treatment. METHODS: The study included 29 patients treated with TDF 245 mg once daily for 18 months after lamivudine monotherapy (LAM arm: n = 15) or sequential therapy with lamivudine and entecavir (LAM → ETV arm: n = 14). The previous antiviral therapy was discontinued due to lack of efficacy. All patients had HBV DNA between 2.1 and 8.23 log(10) IU/ml and 15 were HBeAg-positive, while 45 % of patients had increased ALT activity. Undetectable HBV DNA (<20 IU/ml) at months 3, 6, 12 and 18 was the primary endpoint in the study, while HBeAg/HBsAg loss/seroconversion and ALT normalisation were secondary endpoints. RESULTS: Primary nonresponse to TDF was not observed. HBV DNA was undetectable in 80, 80, 80 and 93 % in LAM arm and 50, 71, 86 and 86 % in LAM → ETV arm patients, at 3, 6, 12 and 18 months of TDF therapy, respectively. One patient achieved anti-HBeAg seroconversion. 86.5 % of patients had normal ALT activity at the end of the study. The baseline HBV DNA load, HBeAg status and the length of the duration of TDF therapy appeared significantly associated with the response to the therapy. HBV DNA clearance occurred faster in HBeAg-negative patients than in those positive for HBeAg. CONCLUSIONS: TDF is an effective antiviral medication in patients with previous exposure to LAM or LAM and ETV. Final proportion of patients who achieved undetectable HBV DNA and had normal ALT activity in both arms, was similar. Springer India 2015-11-26 /pmc/articles/PMC4778152/ /pubmed/26612013 http://dx.doi.org/10.1007/s12072-015-9681-6 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Kozielewicz, Dorota
Halota, Waldemar
Wietlicka-Piszcz, Magdalena
Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment
title Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment
title_full Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment
title_fullStr Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment
title_full_unstemmed Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment
title_short Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment
title_sort tenofovir rescue therapy in chronic hepatitis b patients who failed previous nucleoside analogue treatment
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4778152/
https://www.ncbi.nlm.nih.gov/pubmed/26612013
http://dx.doi.org/10.1007/s12072-015-9681-6
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