Effectiveness of tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B: A protocol for systematic review and meta-analysis.

Objective:To analyze the factors affecting the changes of liver histology in patients with chronic hepatitis B(CHB)and normal alanine aminotransferase(ALT) levelsMethod:The author's hospital were retrospectively studied 209 cases of normal ALT in chronic hepatitis b patients with clinical data,for patient's gender,age and sonographic findings in parenchyma echo,capsule,PV inside diameter,velocity of PV related index correlation with the degree of liver tissue lesionsResult:G1 was 2297%,S1 was 2345%,G2 was 4067%,S2 was 2345%,G3 was 3397%,S3 was 2967%,G4 was 239%,S4 was 2343%Single factor analysis,the grade of inflammation related factors as age,liver capsule,portal vein diameter,the related factors for staging fibrosis liver capsule change with age,MPV;multivariate analysis of factors related to the grade of inflammation and fibrosis were age and liver capsule change Conclusion:Combination of multiple non-invasive index is better than single non-invasive indicator in predicting the changes of liver histology

Characteristics of Liver Histology and the Correlated Index in Patients with Chronic Hepatitis B and Normal ALT Levels

Switching Tenofovir Disoproxil Fumarate (TDF) plus Entecavir Combination Therapy to TDF Monotherapy is Safe and Efficacious in Patients with Multiple Drug-resistant Chronic Hepatitis B: Randomized Trial

Objectives: Currently, both entecavir (ETV) and tenofovir (TDF) are recommended ﬁrst-line therapy for chronic hepatitis B treatment due to good tolerance, lower side-effect profile and high genetic barrier. However, mutations that may develop in the polymerase gene during treatment may result treatment failure. In this study, we aimed to evaluate the efficacy and virologic response of ETV plus TDF combination therapy in chronic hepatitis B patients with suboptimal response to nucleos(t)ide analogues (NAs) monotherapy. Methods: A total of 813 patients who were followed-up with the diagnosis of chronic hepatitis B and who were treated with TDF or ETV monotherapy were screened. Patients who had a partial or non response to monotherapy during at least 12 months and who was the presence of serum HBV-DNA levels ≥ 2000 IU/mL at the time of initiation of the ETV plus TDF combination therapy were included. Results: Ten (1.2%) patients (9 TDF, 1 ETV) were identiﬁed to have had partial response (50%) or breaktrough (40%) or virologic rebound (10%) to monotherapy. The median age was 36.8 years (range, 22-55 years), and 5/10 (50%) patients were male. Of 10 patients, nine of achieved undetectable HBV-DNA (< 15 IU/mL) levels (50% of in 6 months and 90% of in 18 months) with combination therapy. One patient showed no response. Conclusions: Our results suggest that combination therapy is superior to the antiviral change in treatment failure with NAs. In addition, it is important to conduct HBV drug resistance analyzes to prevent false drug change in treatment.

/pdf/tenofovir-plus-entecavir-combination-therapy-for-chronic-1rirrx5eki.pdf

Tenofovir plus entecavir combination therapy for chronic hepatitis B with nucleos(t)ide analogue failure

Background: Chronic hepatitis B virus infection is an important cause of morbidity and mortality. Tenofovir disoproxil fumarate was licensed for the treatment of hepatitis B virus infection. So, the current study aimed to Evaluate efficacy and outcome of Tenofovir Disoproxil Fumarate in patients with Chronic Hepatitis B with High Baseline Viral Load. Patients and methods:One hundred Chronic HBV patients attend Outpatient Clinic of HBV treatment unit, Qena fever hospital, Qena, Egyptwere enrolled in this study and treated with Tenofovir Disoproxil Fumarate (300mg/day) for 24 weeks. Patients categorized into two groups: Group A: included 50 chronic HBV patients with Low Viral load < 1 million/ml and Group B: included 50 chronic HBV patients with High Viral load ≥ 1 million/ml.virological and biochemical response, as well as safety outcomes were assessed after 24 weeks of treatment. Results:The mean age of patients was 38.4 years and 33.9 years in Group A and Group B respectively. Number of males was 32 (64%) and 36 (72%) in Group A and Group B respectively. HBeAg was positive in 20 % and 36 % in Group A and Group B respectively. The rates of complete virological suppression were 88% in group A and 72% in group B. All patients achevied normalization of ALT. No severe adverse events were reported during the present study. No elevations in creatinine level were detected. Conclusion: Tenofovir Disoproxil Fumarate is an efficacious, safe and well-tolerated treatment in an Egyptian patient.

https://svuijm.journals.ekb.eg/article_111898_3346dba2c1fd0594a971d9f325fe5d99.pdf

Efficacy and safety of Tenofovir Disoproxil Fumarate in Patients with Chronic Hepatitis B with High Baseline Viral Load

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, 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.

/pdf/efficacy-of-long-term-treatment-with-tenofovir-in-chinese-27f49u0t8q.pdf

Efficacy of long‑term treatment with tenofovir in Chinese nucleos(t)ide‑naïve chronic hepatitis B patients regardless of baseline viral load

In the present study, the efficacy and safety of tenofovir disoproxil fumarate (TDF) switch therapy were assessed in patients with chronic hepatitis B exhibiting a suboptimal response to adefovir (ADV)-based combination therapy. First, the efficacy of the TDF switch therapy was retrospectively evaluated in 50 patients with chronic hepatitis B who failed to respond to ADV-based combination treatment. Among those, 48 patients with a median age of 35 years were hepatitis B e antigen (HBeAg)-positive and 17, 14 and 19 patients were previously treated with lamivudine (LAM) plus ADV, telbivudine plus ADV and entecavir (ETV) plus ADV, respectively. A total of 41 patients were treated with TDF alone and 9 with TDF plus ETV. The median time of follow-up was 102 weeks. The primary end-point was the cumulative probability of achieving a complete virologic response (CVR). The secondary end-points were the rate of alanine aminotransferase (ALT) normalization, HBeAg seroconversion in HBeAg-positive patients, and the plasma levels of creatinine and creatine kinase. The mean serum hepatitis B virus DNA levels prior to initiation of the TDF switch therapy were 4.8±1.6 log10IU/ml. The cumulative probability of achieving a VR at 24, 48, 96 and 108 weeks was 52.0, 76.0, 89.8 and 94.9%, respectively. The cumulative probability of normalization of ALT at 12, 24, 36, 48, 60,72, 84, 96, 108, 120 and 132 weeks was 34, 44, 50, 58, 66, 70, 74, 80, 90, 92 and 94%, respectively. HBeAg seroconversion was achieved in 5 patients. During the follow-up, 6 patients suffered from a virologic breakthrough, 3 patients failed to respond to the TDF treatment and the remaining patients were able to obtain VR following the continuation of TDF treatment. Slightly elevated serum levels of creatinine were observed in one patient, whereas creatine kinase activity did not increase in any of the subjects. In conclusion, TDF switch therapy is efficient and safe for patients with chronic hepatitis B with a suboptimal response to ADV-based combination therapy.

/pdf/efficacy-of-tenofovir-disoproxil-fumarate-switch-therapy-in-4lg8k6mea8.pdf

Efficacy of tenofovir disoproxil fumarate switch therapy in chronic hepatitis B patients with suboptimal response to adefovir-based combination therapy.

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Efficacy of long‑term treatment with tenofovir in Chinese nucleos(t)ide‑naïve chronic hepatitis B patients regardless of baseline viral load

Efficacy of tenofovir disoproxil fumarate switch therapy in chronic hepatitis B patients with suboptimal response to adefovir-based combination therapy.