Long-Term Efficacy of Tenofovir Monotherapy for Hepatitis B Virus-Monoinfected Patients After Failure of Nucleoside/Nucleotide Analogues

• DOI: 10.1002/hep.23246
• Publication Date: 2009-08-25T16:30:09Z
• Authors: Florian van Bömmel; Robert A. de Man; Heiner Wedemeyer; Katja Deterding; Jörg Petersen; Peter Buggisch; Andreas Erhardt; Dietrich Hüppe; Kerstin Stein; Jörg Trojan; Christoph Sarrazin; Wulf O. Böcher; Ulrich Spengler; Hermann E. Wasmuth; Jurrien G.P. Rein...; Bernd Möller; Peter Rhode; Heinz-Hubert Feucht; Bertram Wiedenmann; Thomas Berg
• Keywords: Tenofovir

Tenofovir disoproxil fumarate (TDF) has demonstrated high antiviral efficacy in treatment-naive patients with chronic hepatitis B virus (HBV) infection but experience nucleoside/nucleotide analogue (NA)-experienced is limited. In this retrospective multicenter study we therefore assessed the long-term of TDF monotherapy prior failure or resistance to different NA treatments. Criteria for inclusion were HBV DNA levels >4.0 log10 copies/mL at start and a minimum period therapy least 6 months. all, 131 (mean age 42 ± 12 years, 95 male, 65% e antigen [HBeAg]-positive) eligible. Pretreatment consisted either lamivudine (LAM; n = 18), adefovir (ADV; 8), sequential LAM-ADV (n 73), add-on combination both drugs 29). Three had failed entecavir therapy. Resistance analysis 113 revealed genotypic LAM ADV 62% 19% patients, respectively. The mean level baseline was 7.6 1.5 copies/mL. overall cumulative proportion achieving <400 79% after treatment duration 23 months (range, 6–60). Although did not influence TDF, presence impaired (100% versus 52% probability copies/mL, respectively). However, virologic breakthrough observed any during entire observation period. Loss HBeAg occurred 24% HBsAg loss 3%. No significant adverse events noticed monotherapy. Conclusion: induced potent long-lasting response NA-experienced previous failure. Our data may have implications current strategies. (Hepatology 2009.)