Tenofovir has inferior efficacy in adefovir-experienced chronic hepatitis B patients compared to nucleos(t)idenaïve patients

Background/Aims: A recent study reported that entecavir had inferior efficacy in nucleos(t)ide analogue (NA)-experienced chronic hepatitis B (CHB) patients compared to NA-naïve patients. We sought to compare the efficacy of tenofovir disoproxil fumarate (TDF) in NA-experienced and NA-naïve CHB patie...

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Published inClinical and molecular hepatology pp. 66 - 73
Main Authors 정고은, 조은주, 이정훈, 유정주, 이민종, 조유리, 이동현, 김휘영, 유수종, 김윤준, 윤정환, Fabien Zoulim
Format Journal Article
LanguageEnglish
Published 대한간학회 01.03.2017
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ISSN2287-2728
2287-285X
DOI10.3350/cmh.2016.0060

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Summary:Background/Aims: A recent study reported that entecavir had inferior efficacy in nucleos(t)ide analogue (NA)-experienced chronic hepatitis B (CHB) patients compared to NA-naïve patients. We sought to compare the efficacy of tenofovir disoproxil fumarate (TDF) in NA-experienced and NA-naïve CHB patients. Methods: We retrospectively enrolled 252 consecutive patients who had a serum hepatitis B virus (HBV) DNA level greater than 2,000 IU/mL at the initiation of TDF treatment and who received TDF for at least 6 months. Complete virologic suppression (CVS) was defined as undetectable serum HBV DNA. We generated a multivariate Cox proportional-hazard model to examine predictive factors that were independently associated with time to CVS. Results: The mean age of patients was 48.2 years, and the cohort included 181 NA-naïve patients and 71 NA-experienced patients. The median duration of TDF treatment was 14.4 (interquartile range, 9.5-17.8) months. A total of 167 (92.3%) of 181 NA-naïve patients achieved CVS, and 60 (84.5%) of 71 NA-exposed patients achieved CVS. Forty-nine (89.1%) of 55 patients who previously took an NA aside from adefovir and 11 (68.8%) of 16 adefovir-experienced patients achieved CVS. In multivariable analysis, previous adefovir exposure significantly influenced time to CVS (hazard ratio, 0.37; 95% confidence interval, 0.19-0.72; P=0.003), after adjusting for HBeAg positivity, baseline HBV DNA level and cirrhosis. Conclusions: Tenofovir had inferior efficacy in adefovir-experienced CHB patients compared to NA-naïve patients. The response of patients with previous adefovir exposure to TDF monotherapy should be monitored closely. KCI Citation Count: 4
Bibliography:http://www.e-cmh.org/journal/view.php?number=1334
G704-001530.2017.23.1.008
ISSN:2287-2728
2287-285X
DOI:10.3350/cmh.2016.0060