Efficacy of tenofovir switch therapy for nucleos(t)ide‐experienced patients with chronic hepatitis B. Issue 11 (31st March 2015)

• Record Type: Journal Article
• Authors: Lo, A. O.‐S.; Wong, V. W.‐S.; Wong, G. L.‐H.; Tse, Y.‐K.; Chan, H.‐Y.; Chan, H. L.‐Y.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 41:Issue 11(2015)
• Page Start: 1190
• Page End: 1199
• Publication Date: 2015-03-31
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.13185
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt13185-abs-0001"> <title>Summary</title> <sec id="apt13185-sec-0001" sec-type="section"> <title>Background</title> <p>Tenofovir disoproxil fumarate has been used in chronic hepatitis B patients with suboptimal virologic response to nucleos(t)ide analogues. The efficacy of tenofovir switch therapy has not been well studied in Asian patients.</p> </sec> <sec id="apt13185-sec-0002" sec-type="section"> <title>Aim</title> <p>To evaluate the efficacy of tenofovir switch therapy in nucleos(t)ide‐experienced patients, and identify the factors associated with treatment response of tenofovir switch therapy.</p> </sec> <sec id="apt13185-sec-0003" sec-type="section"> <title>Methods</title> <p>Nucleos(t)ide‐experienced hepatitis B e antigen‐positive and ‐negative patients prescribed with tenofovir were retrospectively identified and recruited for prospective analysis. Hepatitis B virus (HBV) DNA and other biochemical parameters were monitored in regular 3–6 monthly follow‐up visits. Primary efficacy endpoint was maintained‐virologic response with tenofovir switch therapy, defined as undetectable HBV DNA (<20 IU/mL) until the last follow‐up visit.</p> </sec> <sec id="apt13185-sec-0004" sec-type="section"> <title>Results</title> <p>An overall of 214/252 (84.9%) patients achieved maintained‐virologic response after 22 (7–55) months of tenofovir switch therapy. On multivariate analysis, a lower HBV DNA level at the time of switching to tenofovir was an independent factor associated with treatment efficacy. Maintained‐virologic response after switching to tenofovir was achieved in 177/190 (93.2%) patients with HBV DNA <20 000 IU/mL vs. 37/62 (59.7%) patients with HBV DNA ≥20 000 IU/mL (<italic>P </italic>< 0.001). Absence of genotypic resistance to lamivudine or adefovir dipivoxil was not associated with improved treatment outcome.</p> </sec> <sec id="apt13185-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Tenofovir switch therapy is an effective treatment strategy in nucleos(t)ide‐experienced chronic hepatitis B patients. However, in patients with HBV DNA ≥20 000 IU/mL at the time of switching to tenofovir, the chance of achieving maintained undetectable HBV DNA is significantly reduced.</p> </sec> </abstract>