- 现金
- 62111 元
- 精华
- 26
- 帖子
- 30437
- 注册时间
- 2009-10-5
- 最后登录
- 2022-12-28
|
Clin Gastroenterol Hepatol. 2018 Oct 26. pii: S1542-3565(18)31201-1. doi: 10.1016/j.cgh.2018.10.037. [Epub ahead of print]
Long-term Efficacy of Tenofovir Disoproxil Fumarate Monotherapy for Multidrug-resistant Chronic HBV infection.
Lee HW1, Park JY1, Lee JW2, Yoon KT3, Kim CW4, Park H5, Kim YS6, Paik SK7, Lee JI1, Kim BK1, Han KH1, Ahn SH8.
Author information
1
Department of Internal Medicine, Yonsei University College of Medicine, Seoul.
2
Department of Internal Medicine, Inha University School of Medicine, Incheon.
3
Department of Internal Medicine, Pusan National University School of Medicine, Yangsan.
4
Department of Internal Medicine, The Catholic University College of Medicine, Seoul.
5
Department of Internal Medicine, CHA University College of Medicine, Bundang.
6
Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon.
7
Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea.
8
Department of Internal Medicine, Yonsei University College of Medicine, Seoul. Electronic address: [email protected].
Abstract
BACKGROUND & AIMS:
There are no globally agreed upon treatment guidelines for patients with chronic hepatitis B virus (HBV) with multidrug resistance (MDR). We conducted a multicenter, prospective, real-world cohort study of effects of tenofovir disoproxyl fumarate (TDF) monotherapy and TDF-based combination therapy, as rescue therapy, in patients with multidrug-resistant chronic HBV infections.
METHODS:
We recruited patients with chronic HBV infection with resistance to antivirals from 8 tertiary hospitals in Korea. Patients (n=423) received rescue therapy with TDF monotherapy (n=174) or TDF-based combination therapy (n=249). The median follow-up period was 180 weeks. A virologic response was defined as a serum HBV DNA level of < 20 IU/mL.
RESULTS:
Cumulative rates of virologic response did not differ significantly between the groups that received TDF monotherapy vs. combination therapy at 48 weeks (71.7% vs. 68.9%), 96 weeks (85.1% vs. 84.2%), 144 weeks (92.1% vs. 92.7%), 192 weeks (93.4% vs. 95.7%), or 240 weeks (97.7% vs. 97.2%). Serum levels of HBV DNA below 4.0 log10 IU/mL (odds ratio, 2.478; 95% CI 1.959-3.135; P < 0.001) and the absence of mutations associated with resistance to adefovir (odds ratio, 1.570; 95% CI 1.279-1.926; P < 0.001) were associated with virologic response in patients with MDR. There was no significant difference of virologic response among patients of different ages, sex, patients with vs. without cirrhosis, positivity for hepatitis B e antigen, or renal function (all P > 0.05).
CONCLUSION:
In a multicenter, real-world cohort study, long-term use of TDF monotherapy showed non-inferior antiviral efficacy compared with that of TDF-based combination therapy in patients with MDR.
Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
Hepatitis B; antiviral resistance; rescue therapy; tenofovir
PMID:
30613003
DOI:
10.1016/j.cgh.2018.10.037 |
|