Efficacy of long-term treatment with tenofovir in Chinese nucleoside-naive chronic hepatitis B patients regardless of baseline viral load

• Published in: Experimental and therapeutic medicine Vol. 18; no. 1; p. 260
• Main Authors: Luo, Jie, You, Xu, Chong, Yutian, Wu, Yuankai, Gong, Jiao, Jie, Yusheng, Li, Xinhua, Xi, Sujuan, Zhang, Zhiwei, Zhang, Yufeng, Xie, Dongying, Li, Zhanyi, Li, Xiangyong
• Format: Journal Article
• Language: English
• Published: Spandidos Publications 01-07-2019
• Subjects: Adefovir dipivoxil; Analysis; Antigens; Antiretroviral agents; Care and treatment; Digital video recorders; DNA; Hepatitis B; Hepatitis B virus; Patient compliance; China
• ISSN: 1792-0981
• DOI: 10.3892/etm.2019.7547

The aim of the present study was to analyze the efficacy and safety of tenofovir (TDF) treatment for up to 5 years in nucleos(t)ide-naive chronic hepatitis B (CHB) patients, particularly those with a high viral load, a in real-life scenario. A total of 144 nucleos(t)ide-naive CHB patients who received TDF monotherapy for at least 3 months were retrospectively analyzed. The primary endpoint measure was the achievement of virological response (VR; undetectable serum HBV DNA, <100 IU/ml). The secondary endpoints were alanine aminotransferase (ALT) normalization (ALT < upper limit of normal), hepatitis B e antigen (HBeAg) seroconversion and safety. The median follow-up period was 120 weeks (range, 12-264 weeks). In total, 144, 130, 114, 78, 67, 40 and 13 patients were followed up for at least 12, 24, 48, 96, 144, 192 and 240 weeks, respectively. An incremental trend was observed in the rate of VR: 73.1, 91.3, 98.1, 100, 100 and 100% of the patients exhibited VR at 24, 48, 96, 144, 192 and 240 weeks, respectively. Furthermore, 29 patients with hepatitis B virus (HBV) DNA [greater than or equal to]8 [log.sub.10] IU/ml at baseline achieved VR during the follow-up period. The proportions of patients achieving normal ALT levels were 72.1, 78.6, 91.2, 95, 96 and 100%, at 24, 48, 96, 144, 192 and 240 weeks, respectively. The rate of HBeAg loss reached 35.6% at week 240. Among the 130 patients, HBV DNA was detectable [partial VR (PVR)] in 35 patients at 24 weeks of follow-up, and 30 of those 35 patients (85.7%) required >24 weeks of further TDF therapy to achieve VR. No serious adverse events were reported. In conclusion, long-term TDF treatment of nucleos(t) ide-naive chronic hepatitis B patients, regardless of high viral load at baseline, was effective and safe in a real-life scenario. Adjustment of TDF monotherapy may be unnecessary in nucleos(t)ide-naive patients with PVR at 24 weeks. Key words: hepatitis B, chronic, tenefovir, nucleos(t)ide analogues