Tenofovir in the treatment of naïve and refractory chronic Hepatitis B: A single center experience in Saudi Arabia
Fahad Alsohaibani, Noura Alturaif, Ahmed Abdulshakour, Saad Alghamdi, Alfadel Alshaibani, Hamad Alashgar, Khalid Alkahtani, Ingvar Kagevi
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Correspondence Address:
Fahad Alsohaibani
Department of Medicine, King Faisal Specialist Hospital and Research Centre, MBC 46 P.O Box 3354, Riyadh 11211
Saudi Arabia
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Source of Support: None, Conflict of Interest: None
DOI: 10.4103/1319-3767.164189
Background/Aims: Tenofovir disoproxil fumarate (TDF) is a nucleotide analog used in the treatment of chronic hepatitis B (CHB) infection. This study evaluated the efficacy of TDF in achieving undetectable HBV DNA after 48 weeks of treatment in a Saudi cohort of CHB patients. Patients and Methods: This retrospective study included patients treated at a tertiary care center in Saudi Arabia from January 2009 to December 2012. Of the 68 eligible patients, 51 were treatment naïve and 17 were treatment-refractory. Twenty-three patients tested positive for HBeAg. The remaining 45 patients were HBeAg-negative. Results: The mean HBV DNA viral load decreased from 95 million IU/mL at baseline to 263 IU/mL after 48 weeks of treatment (P < 0.001). Overall, 62% of patients achieved a complete virological response (CVR) and 37% a partial virological response (PVR). Respective CVR and PVR rates according to subgroup were: HBeAg-positive (21.7% and 78.3%) and HBeAg-negative (84.4% and 15.6%). At 48 weeks, HBV DNA was undetectable in 66.7% of treatment-naÏve and 53% of treatment-refractory patients (P = 0.3). Seroconversion occurred in 13 (57%) of HBeAg-positive patients. Two (3%) of the HBeAg-negative patients lost HBsAg at follow up. Mean alanine aminotransferase decreased significantly from 134 U/L before treatment to 37 U/L at 48 weeks (P < 0.001). Significant adverse events were not encountered during the study period. Conclusion: Forty-eight weeks of treatment with TDF reduced HBV DNA to undetectable levels in more than half of our patients regardless of whether they were treatment-naïve or refractory. HBeAg-negative (vs positive) patients experienced a better response rate. 作者: StephenW 时间: 2015-10-1 13:57