Evaluation of the Efficacy of Tenofovir in Chronic Hepatitis B Patients Unresponsive to Lamivudine
Yükleniyor...
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Kronik hepatit B virüs (HBV) enfeksiyonu global bir sağlık problemi olup artmış morbidite ve mortalite ile ilişkilidir. Tedavideki ana hedef HBV replikasyonunu sürekli bir şekilde baskılayabilmektir. Ancak antiviral direnç kalıcı supresyon önünde ciddi bir engel teşkil etmektedir. Ülkemizde lamivude yanıtsız hastalarda tenofovire olan yanıtının değerlendirilmesi ile ilgili yeterli verilerin olmaması nedeniyle, bu çalışmanın yapılması planlanmıştır.Gereç ve Yöntemler: On sekiz yaşından büyük, en az 6 ay lamuvudin kullanmış ve direnç tespit edildikten sonra tenofovir başlanmış 48 hasta çalışmaya alındı. Hastaların tenofovir öncesi ve sonrası HBV DNA düzeyleri, hepatit B e antijen (HBeAg) serokonversiyonu ve hepatit B yüzey antijeni (HBsAg) kaybı oranları retrospektif olarak incelendi.Bulgular: Lamivudin direnci sonrası tenofovir alan hastalarda viral supresyon (HBV DNA 400 kopya/ml) tedavinin 6. ayında %89, 12. ayında %94 ve ortalama 21,4 aylık tedavi sonrası ise %96 oranında saptandı. Alanin aminotransferaz normalizasyonunun tedavinin birinci yılında %60 ve 21,4 aylık izlem süresinin sonunda ise %90 oranında sağlandığı görüldü. Tedavinin birinci yılında HBeAg kaybı %42 hastada tespit edildi. HBsAg kaybı izlem periyodu boyunca hiçbir hastada saptanmadı.Sonuç: Lamivudine yanıtsız kronik hepatit B hastalarında tenofovir etkili ve iyi tolere edilebilen bir tedavi seçeneğidir.
Objective: Chronic hepatitis B virus (HBV) infection is a global health problem and persistent viremia is associated with increased morbidity and mortality. The main goal of hepatitis B treatment is to suppress HBV replication permanently and, antiviral resistance is a major problem against viral suppression. Tenofovir is a potent antiviral drug with no reported resistance so far. There are inadequate data regarding response to tenofovir in chronic hepatitis B patients with lamivudine failure in Turkish population. The present study was conducted to evaluate response of tenofovir in patients with lamivudine failure.Materials and Methods: A total of 48 adult patients with chronic hepatitis B, who have received lamivudine for at least 6 months and switched to tenofovir due to lamivudine failure were investigated retrospectively. HBV DNA levels, alanine aminotransferase (ALT) levels and serum creatinine levels were evaluated before and after tenofovir treatment and also hepatitis B e antigen (HBeAg) seroconversion and hepatitis B surface antigen (HBsAg) loss rates were evaluated.Results: Viral suppression rates (HBV DNA >400 copies/ml) were found to be 89% on the 6th month and 94% on the 12th month of tenofovir treatment. The mean follow-up time was 21.4 months and totally 96% of patients were found to achieve viral suppression with tenofovir. ALT normalization rates were found to be 60% on the first year of treatment with tenofovir and overall ALT normalization rate was 90%. HBeAg seroconversion was detected in 42% of HBe antigen () patients after the first year of tenofovir treatment and disappearance of HBsAg was observed in none of the patients.Conclusion: Tenofovir treatment is an effective and well-tolerated therapeutic option in chronic hepatitis B resistant to lamivudine.
Objective: Chronic hepatitis B virus (HBV) infection is a global health problem and persistent viremia is associated with increased morbidity and mortality. The main goal of hepatitis B treatment is to suppress HBV replication permanently and, antiviral resistance is a major problem against viral suppression. Tenofovir is a potent antiviral drug with no reported resistance so far. There are inadequate data regarding response to tenofovir in chronic hepatitis B patients with lamivudine failure in Turkish population. The present study was conducted to evaluate response of tenofovir in patients with lamivudine failure.Materials and Methods: A total of 48 adult patients with chronic hepatitis B, who have received lamivudine for at least 6 months and switched to tenofovir due to lamivudine failure were investigated retrospectively. HBV DNA levels, alanine aminotransferase (ALT) levels and serum creatinine levels were evaluated before and after tenofovir treatment and also hepatitis B e antigen (HBeAg) seroconversion and hepatitis B surface antigen (HBsAg) loss rates were evaluated.Results: Viral suppression rates (HBV DNA >400 copies/ml) were found to be 89% on the 6th month and 94% on the 12th month of tenofovir treatment. The mean follow-up time was 21.4 months and totally 96% of patients were found to achieve viral suppression with tenofovir. ALT normalization rates were found to be 60% on the first year of treatment with tenofovir and overall ALT normalization rate was 90%. HBeAg seroconversion was detected in 42% of HBe antigen () patients after the first year of tenofovir treatment and disappearance of HBsAg was observed in none of the patients.Conclusion: Tenofovir treatment is an effective and well-tolerated therapeutic option in chronic hepatitis B resistant to lamivudine.
Açıklama
Anahtar Kelimeler
Hepatitis B, Lamivudine, Drug resistance, Tenofovir, Hepatit B, Lamivudin, İlaç direnci, Tenofovir
Kaynak
Viral Hepatitis Journal
WoS Q Değeri
Scopus Q Değeri
Cilt
21
Sayı
3
Künye
Asıl, M., Ataseven, H., Demir, A., Çifçi, S., Kayhan, Y., Güngör, G., Bıyık, M. (2015). Evaluation of the efficacy of tenofovir in chronic hepatitis B patients unresponsive to lamivudine. Viral Hepatitis Journal, 21, 3, 85-88.
