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Long-term Efficacy of Tenofovir Disoproxil Fumarate Monotherapy for Multidrug-Resistant Chronic HBV infection

Authors
 Hye Won Lee  ;  Jun Yong Park  ;  Jin Woo Lee  ;  Ki Tae Yoon  ;  Chang Wook Kim  ;  Hana Park  ;  Young Seok Kim  ;  Soon Ku Paik  ;  Jung Il Lee  ;  Beom Kyung Kim  ;  Kwang-Hyub Han  ;  Sang Hoon Ahn 
Citation
 CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol.17(7) : 1348-1355.e2, 2019 
Journal Title
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 1542-3565 
Issue Date
2019
Keywords
Antiviral Resistance ; Hepatitis B ; Rescue Therapy ; Tenofovir
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 < .001) and the absence of mutations associated with resistance to adefovir (odds ratio, 1.570; 95% CI 1.279-1.926; P < .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 > .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.
Full Text
https://www.sciencedirect.com/science/article/pii/S1542356518312011
DOI
10.1016/j.cgh.2018.10.037
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Jung Il(이정일) ORCID logo https://orcid.org/0000-0002-0142-1398
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173294
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