Tenofovir disoproxil fumarate for patients with chronic hepatitis B who suboptimal response to non-tenofovir disoproxil fumarate nucleos(t)ide analogs therapy

摘要

The efficacy of tenofovir disoproxil fumarate (TDF) for previously nucleos(t)ide analogs (NA)-treated patients in Taiwan is limited. In this retrospective study, our aim is to evaluate the efficacy of TDF in chronic hepatitis B (CHB) with suboptimal response (SR) to non-TDF NA therapy. We retrospectively analyzed CHB patients with SR to non-TDF NA treatment, in Show Chwan Memorial Hospital, Changhua, Taiwan, from September 2011 to December 2018. The primary endpoint was defined as achieving complete virological response (CVR) during TDF therapy. Twenty-eight patients were included in this study. Sixteen (57.1%) patients achieved CVR at a median duration of 135 weeks of TDF therapy. Nine patients (32.1%) achieved CVR early at 24-weeks treatment. One patient developed virological breakthrough during TDF treatment, which was due to poor drug adherence. The remainders had marked HBV DNA virological suppression (HBV DNA < 1000 IU/mL) after TDF treatment. One patient had renal function deterioration after 144 weeks of TDF therapy. Three of 17 (17.6%) patients developed HBeAg seroconversion after TDF treatment. TDF monotherapy is a potent rescue therapy for CHB patients with SR to non-TDF NA. Closely monitor renal function is necessary especially in patient with renal dysfunction initially.