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Viral Hepatitis
Tenofovir disoproxil fumarate in Asian or Pacific Islander chronic hepatitis B patients with high viral load (≥ 9 log10 copies/ml)
Scott Fung1,*,
Stuart C. Gordon2,
Zahary Krastev3,
Andrzej Horban4,
Jörg Petersen5,
Jan Sperl6,
Edward Gane7,
Ira M. Jacobson8,
Leland J. Yee9,
Phillip Dinh9,
Eduardo B. Martins9,
John F. Flaherty9,
Kathryn M. Kitrinos9,
Geoffrey Dusheiko10,
Huy Trinh11,
Robert Flisiak12,
Vinod K. Rustgi13,
Maria Buti14 and
Patrick Marcellin15
Article first published online: 28 OCT 2014
DOI: 10.1111/liv.12694
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Issue
Liver International
Volume 35, Issue 2, pages 422–428, February 2015
Article has an altmetric score of 4
Additional Information(Show All)
How to CiteAuthor InformationPublication HistoryFunding Information
Author Information
1 University of Toronto, Ontario, Canada
2 Henry Ford Health System, Detroit, MI, USA
3 University Hospital, St. Ivan Rilsky, Sofia Bulgaria
4 Warsaw Medical University, Warsaw, Poland
5 Liver Unit Asklepios Klinik St. Georg, Hamburg, Germany
6 Institute for Clinical and Experimental Medicine, Prague, Czech Republic
7 Auckland City Hospital, Aukland, New Zealand
8 Weill Cornell Medical College, New York, NY, USA
9 Gilead Sciences Inc., Foster City, CA, USA
10 Royal Free Hospital, London, UK
11 San Jose Gastroenterology, San Jose, CA, USA
12 Medical University of Bialystok, Bialystok, Poland
13 Metropolitan Liver Diseases, Fairfax, VA, USA
14 Hospital General Universitari Vall d'Hebron and Ciberehd del Instituto Carlos III, Barcelona, Catalonia, Spain
15 Hôpital Beaujon, University of Paris, Clichy, France
* Correspondence
Scott Fung, MD, FRCPC
200 Elizabeth St., 9N-981
Toronto General Hospital
University Health Network
Toronto, ON, M5G 2C4, Canada
Tel: +416 340 3893
Fax: +416 340 3258
e-mail: [email protected]
Abstract
Background & Aims
We evaluated the antiviral response of Asian or Pacific Islander (API) patients with chronic hepatitis B (CHB) who had baseline high viral load (HVL), defined as pre-treatment hepatitis B virus (HBV) DNA ≥9 log10 copies/ml, following up to 288 weeks of tenofovir disoproxil fumarate (TDF) treatment.
Methods
A total of 205 HBeAg-negative and HBeAg-positive self-described API patients received 48 weeks of TDF 300 mg (HVL n = 18) or adefovir dipivoxil 10 mg (HVL n = 15) in a blinded fashion, followed by open-label TDF for an additional 240 weeks. The proportions of HVL vs. non-HVL patients with HBV DNA <400 copies/ml were compared. Mean declines in HBV DNA were evaluated in API vs. non-API patients.
Results
Throughout the first 72 weeks of treatment, a smaller proportion of HVL API patients reached HBV DNA <400 copies/ml than non-HVL API patients. However, after this timepoint similar proportions of HVL and non-HVL API patients achieved HBV DNA <400 copies/ml (100% vs. 97%, respectively), which was maintained through week 288, where 92% of HVL patients and 99% of non-HVL API patients on treatment had HBV DNA <400 copies/ml. During the 288 weeks of treatment, API patients had similar mean HBV DNA declines as non-API patients, regardless of whether patients were HVL or non-HVL. No API HVL patient had persistent viremia at week 288. No resistance was detected among HVL or non-HVL patients.
Conclusions
API patients with HVL CHB achieve HBV DNA <400 copies/ml with long-term TDF treatment; however, achieving viral suppression may take longer for HVL patients relative to non-HVL API patients.
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