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Long-term efficacy of tenofovir disoproxil fumarate therapy after multiple nucleos(t)ide analogue failure in chronic hepatitis B patientsopen accessLong-term efficacy of tenofovir disoproxil fumarate therapy after multiple nucleos(t)ide analogue failure in chronic hepatitis B patients

Other Titles
Long-term efficacy of tenofovir disoproxil fumarate therapy after multiple nucleos(t)ide analogue failure in chronic hepatitis B patients
Authors
Kim, HJ[Kim, Hyo Jin]Cho, JY[Cho, Ju-Yeon]Kim, YJ[Kim, Yu Jin]Gwak, GY[Gwak, Geum-Youn]Paik, YH[Paik, Yong-Han]Choi, MS[Choi, Moon Seok]Koh, KC[Koh, Kwang Cheol]Paik, SW[Paik, Seung Woon.]Yoo, BC[Yoo, Byung Chul]Lee, JH[Lee, Joon Hyeok]
Issue Date
Jan-2015
Publisher
KOREAN ASSOC INTERNAL MEDICINE
Keywords
Tenofovir; Hepatitis B, chronic; Treatment failure; Resistance
Citation
KOREAN JOURNAL OF INTERNAL MEDICINE, v.30, no.1, pp.32 - 41
Indexed
SCIE
SCOPUS
KCI
Journal Title
KOREAN JOURNAL OF INTERNAL MEDICINE
Volume
30
Number
1
Start Page
32
End Page
41
URI
https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/44987
DOI
10.3904/kjim.2015.30.1.32
ISSN
1226-3303
Abstract
Background/Aims: The efficacy of tenofovir disoproxil fumarate (TDP) for the treatment of chronic hepatitis B (CHB) patients following prior treatment failure with multiple nucleos(t)ide analogues (NAs) is not well defined, especially in Asian populations. In this study we investigated the efficacy and safety of TDF rescue therapy in CHB patients after multiple NA treatment failure. Methods: The study retrospectively analyzed 52 CHB patients who experienced failure with two or more NAs and who were switched to regimens containing TDF. The efficacy and safety assessments included hepatitis B virus (HBV) DNA undetectability, hepatitis B envelop antigen (HBeAg) seroclearance, alanine transaminase (ALT) normalization and changes in serum creatinine and phosphorus levels. Results: The mean HBV DNA level at baseline was 5.4 +/- 1.76 log(10) IU/mL. At a median duration of 34.5 months of TDF treatment, the cumulative probabilities of achieving complete virological response (CVR) were 25.0%, 51.8%, 74.2%, and 96.7% at 6, 12, 24, and 48 months, respectively. HBeAg seroclearance occurred in seven of 48 patients (14.6%). ALT levels were normalized in 27 of 31 patients (87.1%) with elevated ALT at baseline. Lower levels of HBV DNA at baseline were significantly associated with increased CVR rates (p < 0.001). However, CVR rates did not differ between TDF monotherapy or combination therapy with other NAs, and were not affected by mutations associated with resistance to NAs. No significant adverse events were observed. Conclusions: TDF is an efficient and safe rescue therapy for CHB patients after treatment failure with multiple NAs.
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