EASL2012: Treatment with Tenofovir - 4 Abstracts

StephenW

Abstract               
                                

Title	FACTORS ASSOCIATED WITH REGRESSION OF CIRRHOSIS IN PATIENTS WITH CHORNIC HEPATITIS B (CHB) INFECTION TREATED WITH TENOFOVIR DISOPROXIL FUMARATE (TDF)
Speaker:	Nezam   Afdhal
Author:	N. Afdhal1*, M. Buti2, S. Fung3, E. Gane4, J. Flaherty5, E. Martins5, N. Bekele5, J. Bornstein5, P. Marcellin6
Affiliation:	1Harvard Medical School, Boston, MA, USA, 2Servei de Medicina Interna-Hepatologia, Vall d'Hebron Hospital General, Barcelona, Spain, 3Univeristy of Toronto, Toronto, ON, Canada, 4Auckland City Hospital, Auckland, New Zealand, 5Gilead Sciences, Foster City, CA, USA, 6Hopital Beaujon, Clichy, France. *[email protected]
Regression of fibrosis is an important clinical outcome for patients with CHB who achieve long term viral suppression with nucleos(t)ide therapy. It has been previously reported that up to 5 years of TDF therapy results in a regression of cirrhosis in 74% of patients. The clinical and pathophysiologic differences between those that had reversal and those that did not has not been described. Methods: A retrospective analysis was conducted on 96 cirrhotic patients (Ishak fibrosis stage ≥ 5) who had liver biopsies at baseline and at year 5 in 2 studies that compared the safety and efficacy of TDF to adefovir for 48 weeks in HBeAg negative (Study 0102) and HBeAg positive (Study 0103) patients, followed by open-label TDF treatment for an additional 7 years. Results: 96 patients with cirrhosis at baseline had follow-up biopsies at year 5. 71 of the 96 (74%) were no longer cirrhotic (Ishak fibrosis stage ≤ 4). Among the different baseline covariates assessed, elevated body weight (87.4 kg vs. 76.8 kg, p=0.013) and body mass index (BMI) (29.0 kg/m2 vs 25.7 kg/m2, p< 0.001) were the only variables that were significantly correlated with persistent cirrhosis. Age, gender, race, viral genotype, inflammation, platelet count, albumin, ALT, and DNA and HBsAg titers did not correlate. There was a trend showing that patients with a shorter time since diagnosis and those with Ishak fibrosis stage 5 were more likely regress than those with longer duration of infection and Ishak stage 6 fibrosis. Subjects who were no longer cirrhotic were more likely than those with persistent cirrhosis to have a normal ALT at year 5, but no other differences were noted in outcomes for those that resolved cirrhosis vs. those that did not. Both groups had similar increases in platelet counts and albumin levels, similar rates of HBeAg loss, viral suppression, and HCC rates. No patient in either group had ascites, variceal bleeding or hepatic encephalopathy. Conclusion: TDF therapy results in a high rate of cirrhosis reversal. Persistence of cirrhosis is most likely when risk factors for a 2nd disease such as obesity induced liver disease co-exists.

StephenW

标题因素相关CHORNIC乙型肝炎（CHB）富马酸替诺福韦酯（TDF）治疗感染患者肝硬化回归
主讲人：Nezam Afdhal
作者：北Afdhal1 *，M. Buti2，S. Fung3 E。Gane4，J. Flaherty5，大肠杆菌Martins5，Bekele5北路，Bornstein5研究，P. Marcellin6“
单位：1Harvard医学院，波士顿，马萨诸塞州，美国，2Servei的MEDICINA国际Hepatologia，瓦尔德希伯伦医院一般，巴塞罗那，西班牙，多伦多，多伦多3Univeristy为ON，加拿大，市立医院4Auckland，奥克兰，新西兰，5Gilead科学，福斯特市，美国加利福尼亚，6Hopital Beaujon，克利希，法国。 * [email protected]
纤维化的回归，是一个重要的实现长期抑制病毒的核苷（酸）IDE治疗慢性乙型肝炎患者的临床疗效。先前已报道，至5年74％的患者在肝硬化回归TDF的治疗结果。之间那些有逆转和那些没有临床和病理生理上的差异并没有被描述。
方法：回顾性分析96例肝硬化患者（Ishak纤维化分期≥5）曾在基线和2研究5年的肝活检相比，TDF的安全性和有效性，为48周，HBeAg阴性（研究0102阿德福韦进行）和HBeAg阳性患者（研究0103），其次是一个额外的7年的开放标签TDF的治疗。
结果：96例患者在基线肝硬化后续5年的活组织切片检查。 71 96（74％）已不再是肝硬化（Ishak纤维化阶段≤4）。在不同的基线协变量评估，高架体重（87.4公斤与76.8公斤，P = 0.013）和身体质量指数（BMI）（29.0 kg/m2比25.7 kg/m2，P <0.001），是唯一的变量持续性肝硬化显着正相关。年龄，性别，种族，病毒基因型，炎症，血小板计数，白蛋白，谷丙转氨酶，DNA和乙肝表面抗原滴度没有关联。有趋势显示，自诊断和Ishak纤维化阶段5较短的时间内患者多，持续时间较长的感染和伊沙克阶段6纤维化那些可能回归。没有再肝硬化的主题是超过5年有一个正常的ALT持续性肝硬化的可能，但没有其他的差异，为这些成果中指出，与那些没有解决的肝硬化。血小板计数和白蛋白水平相似率，HBeAg消失，抑制病毒和肝癌率两组有类似的增长。没有在任何一组的病人有腹水，食管静脉曲张破裂出血或肝性脑病。
结论：在肝硬化的逆转率很高的TDF的治疗结果。持久性肝硬化是最有可能时，肥胖引起的肝脏疾病并存，如第二个疾病的危险因素。

StephenW

Abstract               
                                

Title	CLINICAL, VIROLOGICAL, SEROLOGICAL AND HISTOLOGICAL OUTCOMES IN CIRRHOTIC PATIENTS WITH CHRONIC HEPATITIS B (CHB) TREATED WITH TENOFOVIR DISOPROXIL FUMARATE (TDF) FOR UP TO 5 YEARS
Speaker:	Maria   Buti
Author:	M. Buti1*, S. Fung2, E. Gane3, N. Afdhal4, J. Flaherty5, E. Martins5, N. Bekele5, J. Bornstein5, P. Marcellin6
Affiliation:	1Servei de Medicina Interna-Hepatologia, Vall d'Hebron Hospital General, Barcelona, Spain, 2Univeristy of Toronto, Toronto, ON, Canada, 3Auckland City Hospital, Auckland, New Zealand, 4Harvard Medical School, Boston, MA, 5Gilead Sciences, Foster City, CA, USA, 6Hopital Beaujon, Clichy, France. *[email protected]
CHB suppression with TDF improves transaminases, results in a regression of liver fibrosis and increases HBeAg seroconversion. Long term data in cirrhotic patients is needed. Methods: A retrospective analysis of 2 pivotal studies of TDF was conducted to assess whether cirrhotic patients had different clinical outcomes than non-cirrhotic patients. In these studies, the safety and efficacy of TDF compared to adefovir was assessed for 48 weeks in HBeAg negative (Study 0102) and HBeAg positive (Study 0103) patients, followed by open-label TDF treatment. Results: A total of 634 subjects were included. Cirrhotics had outcomes comparable to non-cirrhotics (see tables). Parameter Baseline Cirrhotic (n=152) Baseline Non-cirrhotic (n=482) P-Value % >40 years old 68% 45% <0.001 % male 81% 72% 0.022 Mean BMI (kg/m^2) 26.5 25.1 <0.001 Mean platelets (x10^3) 178 219 <0.001 Mean albumin (g/dL) 4.0 4.2 <0.001 [Baseline Characteristics of Cirrhotics vs. Non-cir] Parameter Baseline Cirrhosis (n=152) Baseline Non-cirrhosis (n=482) P-Value HBV DNA < 400 copies/ml 99% 98% NS ALT < ULN 80% 82% NS HBeAg loss 62% 45% 0.066 HBsAg loss 2% 3% NS Mean increase in platelets (x10^3) 31 20 0.03 Mean increase in albumin (g/dL) 0.27 0.1 <0.001 Fibrosis: regression 74% 42% NA Fibrosis: no change 25% 54% NA Fibrosis: worsening 1% 1% NA [Year 5 Comparison of Cirrhotics and Non-cirrhotics] There were no cases of hepatic encephalopathy or variceal bleeding in either group, and ascites occurred in one non-cirrhotic patient with HCC. The incidence of HCC was 1.5% in non-cirrhotics and 3.3% in cirrhotics (p=NS). Conclusions: Cirrhotic patients differed from non-cirrhotic subjects at baseline, but demonstrated significant treatment benefits with 74% experiencing regression of cirrhosis. Cirrhotic patients treated with TDF had similar rates of viral suppression and serological responses as non-cirrhotics and derived comparable clinical benefit after 5 years of viral suppression.

StephenW

富马酸替诺福韦酯（TDF）治疗长达5年的标题临床，病毒学，血清学和组织学肝硬化患者与慢性乙型肝炎（CHB）的成果
主讲人：玛丽亚Buti
作者：Buti1研究*，S. Fung2，E. Gane3，N. Afdhal4，J. Flaherty5，大肠杆菌Martins5，N Bekele5研究Bornstein5，P. Marcellin6“
单位：1Servei国际Hepatologia，瓦尔德希伯伦医院普，巴塞罗那，西班牙，多伦多，多伦多2Univeristy为ON，加拿大，市立医院3Auckland，奥克兰，新西兰，医学院4Harvard，波士顿，马，5Gilead科学MEDICINA，福斯特市美国加利福尼亚，6Hopital Beaujon，克利希，法国。 * [email protected]
慢性乙型肝炎与TDF的抑制，提高转氨酶在肝纤维化的回归，结果，提高HBeAg血清转换。肝硬化患者的长期数据是必要的。
方法：回顾性分析2 TDF的关键研究进行了评估肝硬化患者是否有比非肝硬化患者不同的临床结果。在这些研究中，阿德福韦相比TDF的安全性和有效性进行了评估，为48周，HBeAg阴性（研究0102）和HBeAg阳性患者（研究0103），随后开放标签TDF的治疗。
结果：共纳入634科目。肝硬化有结果与非肝硬化（见表）。

参数                  基线肝硬化 (N = 152）              基线非肝硬化组（n = 482），P值
％> 40多年老                    68％，                       45％                             <0.001
％男性                             81％，                        72％                              0.022
平均体重（公斤/米^ 2）     26.5                            25.1                            <0.001
平均血小板（X10 ^ 3）      178                             219                             <0.001
平均白蛋白（克/升）          4.0                             4.2                              <0.001
[肝硬化与非CIR基线特征]



参数                 基线肝硬化（N = 152）               基线非肝硬化组（n = 482），P值
乙型肝炎病毒DNA <400拷贝/ ml，99％，              98％                                   NS
ALT <正常值上限                        80％                 82％                                   NS
HBeAg消失                                62％，              45％                               0.066
HBsAg转阴                                 2％，                3％                                   NS
平均增加血小板（X10 ^ 3）            31                 20                                    0.03
平均增加白蛋白（克/升）              0.27                0.1                                <0.001
纤维化：回归                              74％                42％                                  NA
纤维化：没有变化                        25％，             54％                             不适用
纤维化恶化                                  1％，              1％                               不适用
[5年肝硬化和非肝硬化的比较]


有没有在两个组中肝性脑病或食管静脉曲张破裂出血，发生在一个非肝硬化与肝癌患者的腹水。在非肝硬化，肝癌的发病率分别为1.5％和3.3％的肝硬化患者（P = NS）。
结论：肝硬化患者从基线非肝硬化科目不同，但表现出显着的治疗效益，有74％经历肝硬化回归。与TDF的治疗肝硬化患者有抑制病毒和血清学非肝硬化和派生类似的抑制病毒的5年后的临床受益反应率相似。 。

StephenW

Abstract               
                                

Title	IS HBeAg LOSS ASSOCIATED WITH AN IMPROVED OUTCOME IN HEPATITIS B PATIENTS TREATED WITH TENOFOVIR DISOPROXIL FUMARATE (TDF)?
Speaker:	Scott   Fung
Author:	S. Fung1*, M. Buti2, E. Gane3, N. Afdhal4, J. Flaherty5, E. Martins5, N. Bekele5, J. Bornstein5, P. Marcellin6
Affiliation:	1University of Toronto, Toronto, ON, Canada, 2Servei de Medicina Interna-Hepatologia, Vall d'Hebron Hospital General, Barcelona, Spain, 3Auckland City Hospital, Auckland, New Zealand, 4Harvard Medical School, Boston, MA, 5Gilead Sciences, Foster City, CA, USA, 6Hopital Beaujon, Clichy, France. *[email protected]
In patients with chronic hepatitis B (CHB) infection, spontaneous HBeAg seroconversion is a key event in the transition from active hepatitis to the inactive carrier state, which is associated with improved prognosis. It is unclear whether nucleos(t)ide analogue-induced HBeAg loss produces a similar benefit and whether therapy should be stopped once this outcome is achieved. Methods: A retrospective analysis was conducted on HBeAg positive subjects enrolled in study GS-US-0174-103 that compared TDF to adefovir for 1 year followed by open-label TDF for up to 7 years. Subjects who lost HBeAg were compared to those remained HBeAg-positive at the end of year 5. Results: 165 subjects were included, of whom 81 (49%) became HBeAg negative while 84 (51%) remained HBeAg positive. Baseline characteristics associated with a higher likelihood of HBeAg loss on treatment included age > 40 years (46% vs. 24%, p=0.003), genotype A (37% vs. 10%, p< 0.001), higher hepatic necroinflammatory score (mean Knodell 9 vs. 8, p=0.038), lower serum HBV DNA (8.42 vs. 8.90 Log10 copies/ml, p=0.002) and lower HBsAg levels (55,000 vs. 65,000 IU/ml, p=0.052). Subjects who achieved HBeAg loss at year 5 were more likely to have undetectable HBV DNA (100% vs. 94%, p=0.026) as well as HBsAg loss (10% vs. 0%, p=0.003) and HBsAg seroconversion to anti-HBs (7% vs. 0%, p=0.011). No significant differences were observed between the groups in terms of reduction of hepatic inflammation, regression of fibrosis, development of hepatocellular carcinoma and or hepatic decompensation. Conclusions: Older patients with more hepatic inflammation, lower HBV DNA and HBsAg levels and HBV genotype A infection were more likely to become HBeAg negative on TDF therapy. Subjects who lost HBeAg were more likely to have undetectable HBV DNA and to also lose HBsAg . No difference in long-term clinical outcomes was noted, although longer follow-up and long-term therapy are likely necessary to detect such differences.

StephenW

标题是HBeAg的富马酸替诺福韦酯（TDF）治疗乙型肝炎患者改善的结果与相关的损失呢？
主讲人：斯科特丰
：学Fung1 *，M. Buti2，E. Gane3，N. Afdhal4，J. Flaherty5，大肠杆菌Martins5，N Bekele5研究Bornstein5，P.的Marcellin6
单位：ON，加拿大多伦多，多伦多，1University，2Servei的MEDICINA国际Hepatologia，瓦尔德，西班牙，巴塞罗那希伯伦医院一般市立医院3Auckland，奥克兰，新西兰，医学院4Harvard，波士顿，麻省，5Gilead科学，福斯特市美国加利福尼亚，6Hopital Beaujon，克利希，法国。 * scott.fung @ uhn.ca
在慢性乙型肝炎（CHB）感染的患者，自发HBeAg血清转换是一个关键事件中的活动性肝炎，非活动携带状态的过渡，这是改善预后相关。这是核苷（酸）IDE模拟诱导HBeAg的损失目前还不清楚是否会产生类似的好处，是否一旦实现这一结果，应停止治疗。
方法：回顾性分析进行阿德福韦1年相比，TDF的开放标签TDF的长达7年的随访，对HBeAg阳性受试者参加研究GS美-0174-103。科目谁失去了HBeAg的进行比较，以保持在今年5月底，HBeAg阳性者。
结果：165个受试者，其中81人（49％），成为HBeAg阴性，而84（51％）保持HBeAg阳性。与治疗的HBeAg损失的可能性更高的基线特征包括年龄> 40岁（46％比24％，P = 0.003），基因型（37％比10％，P <0.001），较高的肝脏坏死性炎症评分（平均Knodell 9与8，P = 0.038），降低血清HBV DNA（8.42比8.90 log10拷贝/毫升，P = 0.002）和HBsAg水平低（55000  -  65000 IU / ml时，P = 0.052）。在5年取得的HBeAg消失的主题更可能有不到乙肝病毒DNA（100％和94％，P = 0.026）以及HBsAg消失（10％和0％，P = 0.003）和抗HBsAg血清转换-HBs阳性（7％和0％，P = 0.011）。减少肝脏炎症，纤维化的回归，发展肝癌和肝功能失代偿组之间无显着差异，观察。
结论：老年患者肝脏炎症，降低血清HBV DNA和HBsAg水平和一个感染乙肝病毒基因型的人更有可能成为对TDF的治疗HBeAg的负。科目谁失去了HBeAg的人更可能有不到乙肝病毒DNA，也失去了乙肝表面抗原。没有差异，在长期的临床结果指出，虽然长期随访和长期治疗可能是必要的，以检测这种差异。

StephenW

Abstract               
                                

Title	A European field study of the efficacy and safety of Tenofovir disoproxil fumarate (TDF) as monotherapy in patients with prior failure to other nucleoside/nucleotide analogues
Speaker:	Florian   van Bömmel
Author:	F. van Bömmel1*, R. Zoutendijk2, R. de Man3, J.-P. Bronowiki4, K. Rutter5, P. Ferenci5, H. Janssen2, B. Fülöp1, A. Brodzinski1, J. Wiegand1, H. Wedemeyer6, K. Deterding6, A. Erhardt7, D. Hüppe8, M. Bourlière9, C. Sarrazin10, J. Trojan10, P. Buggisch11, J. Petersen11, U. Spengler12, A. Kamp13, S. Mauss13, M. Schuchmann14, K. van Nieuwkerk15, T. Gerlach16, D. Moradpour17, A. Schweinberger1, H. Wasmuth18, T. Berg1
Affiliation:	1Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Universitätsklinik Leipzig, Leipzig, Germany, 2Erasmus MC Rotterdam, 3Gastroenterology, Erasmus MC University Hospital, Rotterdam, The Netherlands, 4Service d'Hépato-Gastroentérologie, CHU de Nancy, Nancy, France, 5Medical University of Vienna, Vienna, Austria, 6Medizinische Hochschule Hannover, Hannover, 7Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, 8Gastroenterologische Gemeinschaftspraxis Herne, Herne, Germany, 9Hôpital St Joseph, Marseille, France, 10Johann Wolfgang Goethe University Medical Center, Frankfurt/Main, 11IFI Institut Asklepios Klinik St Georg, Hamburg, 12Universitätsklinikum Bonn, Bonn, 13Center for HIV and Hepatogastroenterology, Düsseldorf, 14Universitätsklinikum Mainz, Mainz, Germany, 15VU Medisch Centrum, Amsterdam, The Netherlands, 16Klinik Augustinum, München, Germany, 17Centre Hospitalier Universitaire Lausanne, Lausanne, Switzerland, 18University Hospital Aachen, Aachen, Germany. *[email protected]
Background: Monotherapy with tenofovir disoproxil fuarate (TDF) is effective in patients who are treatment naïve and in patients after failure to treatment with other nucleoside/nucleotide analogues (NUCs). In this study, we have assessed the efficacy of long term TDF treatment in patients with preceding failure to other NUCs in a real life setting. Methods: Patients receiving monotherapy with TDF 245 mg per day after failure to other NUCs were identified in 22 European centres. Inclusion criteria were: age ≥ 18 years, duration of TDF treatment ≥ 6 months, re-increase of HBV DNA > 1 log10 from nadir during preceding NUC treatment, exclusion of non compliance as stated by the treating physician. HBV DNA was measured using a real time PCR based assay (Roche Amplicor, lower detection limit 400 copies/mL). Results: 589 patients receiving monotherapy with TDF for a mean duration of 44±24 [range, 9-122] months after failure to NUC treatment were retrospectively analyzed in 18 European centers (mean age 44±13[range, 18-76] years, 74% male, 54% HBeAg positive). Pre-treatment included lamivudine (n=426), adefovir (n=374), telbivudine (n=13) and entecavir (n=16). HBV DNA levels decreased from 5.6±2.3 [2.8-10.3] to 2.6±13 [2.6-4.4] after 12 and to 2.6±0.9 [18-3.1] after 24 months, respectively. HBV DNA was detectable in 6 patients at months 24, all of them who had been pre-treated with ADV. No re-increase of HBV DNA levels > 1 log10 was observed. HBeAg and HBsAg losses was observed in 60 (20%) and 11 (2%, all HBeAg positive) patients after a mean duration of 12±12 [1-55] and 15±12 [range, 1-36] months, respectively. Mean glomerular filtration rates changed from 67±35 [34-124] to 63±55 [36-118] at months 24 (p=0.87). No patient with initial glomerular filtration rate > 50 ml/min showed a decrease to values < 50 ml/min. TDF treatment was stopped in one patient due to enteritis. Conclusion: In a real life setting, TDF as monotherapy represents an effective and safe option for long term treatment for patients with prior failure to NUC treatment.

StephenW

标题在事先衰竭患者的单一欧洲的富马酸替诺福韦酯（TDF）的疗效和安全领域研究的其他核苷/核苷酸类似物
主讲人：弗洛里安·范博梅尔
作者：楼面包车Bömmel1*，河，河的Man3，J.-P. Zoutendijk2 bronowiki4，K. Rutter5，J. Wiegand1，A. Brodzinski1，BFülöp1，H. Janssen2，P. Ferenci5，H。Wedemeyer6，Deterding6光，A Erhardt7，DHüppe8，研究Bourlière9，Sarrazin10三， J. Trojan10，体育Buggisch11 J. Petersen11，U. Spengler12，A Kamp13，与Mauss13，Schuchmann14研究，光面包车Nieuwkerk15，吨Gerlach16，D Moradpour17，A. Schweinberger1，H。Wasmuth18，T 。Berg1
单位：献给Gastroenterologie，2ErasmusUniversitätsklinik莱比锡，莱比锡，德国的MC鹿特丹，3Gastroenterology，Erasmus MC大学医院，鹿特丹，荷兰，4Service德，朱南锡，南锡，法国，肝Gastroentérologie5Medical大学和Rheumatologie，1Klinik和Poliklinik维也纳，维也纳，奥地利，6Medizinische Hochschule的汉诺威，汉诺威，7UniversitätsklinikumDER海因里希 - 海涅大学的杜塞尔多夫，杜塞尔多夫，8Gastroenterologische Gemeinschaftspraxis赫恩，赫恩，德国，圣约瑟夫9Hôpital，马赛，法国，10Johann·沃尔夫冈·歌德大学医学中心，法兰克福/主，11IFI研究所阿斯科勒比俄斯Klinik圣格奥尔格，汉堡，12Universitätsklinikum波恩，波恩，艾滋病毒和胃肠肝胆，杜塞尔多夫，14Universitätsklinikum美因茨，美因茨，德国，15VU医学中心的，荷兰阿姆斯特丹，16Klinik Augustinum，慕尼黑，德国，洛桑大学医学17Centre 13Center ，洛桑，瑞士，德国，18University医院亚琛，亚琛。 * florian.vanboemmel medizin.uni-leipzig.de
背景：单药治疗替诺福韦fuarate的（华盈）是在与其他核苷/核苷酸类似物（NUCs）治疗失败后的治疗天真和患者的病人谁是有效的。在这项研究中，我们已经评估长长期TDF的治疗患者前未能在现实生活中设置的其他NUCs的疗效。
方法：患者接受单一失败后与TDF的每天245毫克，其他NUCs被确定在22个欧洲的中心。入选标准：年龄≥18岁，≥6个月，从低谷再增加的HBV DNA> 1 log10的前处理国统会，由主治医生说，排除不符合在TDF的治疗时间。乙型肝炎病毒DNA测定采用实时PCR为基础的检测（罗氏AMPLICOR，检出限低400拷贝/ ml）。
结果：589例患者接受TDF的单药治疗失败后国统会处理的平均时间为44±24范围9-122]个月内进行回顾性分析，在欧洲18个中心（平均年龄44±13 [范围，18-76岁，74％为男性，54％的HBeAg阳性）。前处理包括拉米夫定，阿德福韦组（n = 374）（N = 426），替比夫定组（n = 13）和恩替卡韦组（n = 16）。 HBV DNA水平下降至5.6±2.3 [2.8-10.3]±13 2.6 [2.6-4.4]后12和2.6±0.9 18-3.1后24个月，分别。乙型肝炎病毒DNA被检测出6例在24个月，他们都用ADV已预先处理。没有再增加HBV DNA水平> 1 log10的观察。 HBeAg和HBsAg的损失平均时间12±12 [1-55]和15±12范围1-36个月后，分别在60（20％）和11例（2％，所有HBeAg阳性） 。平均肾小球滤过率从67更改为±35 [34-124]为63±55 [36-118]在24个月（P = 0.87）。病人没有初始肾小球滤过率> 50毫升/分钟显示值减少<50毫升/分钟。 TDF的治疗停止在一个病人因肠炎。
结论：在现实生活中的设置，作为单一的TDF的代表前到国统会治疗失败的患者长期治疗的有效和安全的选择。

咬牙硬挺

哈哈，替诺福韦很给力啊！感谢楼主带来的好消息

XYBHX

好消息，谢谢楼主！