title: Successful switch to tenofovir after suboptimal response to entecavir in an immunocompromised patient with chronic hepatitis B and without genotypic hepatitis B virus resistance.
abstract: We report a case of an immunocompromised patient affected by chronic hepatitis B virus (HBV) with high basal HBV viremia (>8 log(10) IU/ml) who failed an entecavir regimen, despite the absence of primary or secondary drug resistance mutations. The patient achieved sustained virological success (serum HBV DNA <12 IU/ml) when tenofovir was added to the treatment. This case highlights the difficulty in choosing an optimal therapy in such specific conditions and supports the concept of tailoring therapy (including combination regimens) on the basis of the particular conditions of each individual patient.
authors.affiliation: Department of Public Health, University of Rome Tor Vergata, Rome, Italy. sarrecchia@med.uniroma2.it
authors.forename: C
authors.initials: C
authors.lastname: Sarrecchia
authors.forename: V
authors.initials: V
authors.lastname: Svicher
authors.forename: A
authors.initials: A
authors.lastname: Volpi
authors.forename: R
authors.initials: R
authors.lastname: Salpini
authors.forename: L
authors.initials: L
authors.lastname: Ceccarelli
authors.forename: P
authors.initials: P
authors.lastname: Sordillo
authors.forename: A
authors.initials: A
authors.lastname: Bertoli
authors.forename: C F
authors.initials: CF
authors.lastname: Perno
authors.forename: M
authors.initials: M
authors.lastname: Andreoni
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D001853:Bone Marrow / Q000276:immunology* / Q000503:physiopathology; D004279:DNA, Viral / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D007558:Italy; D063065:Organophosphonates / Q000627:therapeutic use*; D000068698:Tenofovir; D016896:Treatment Outcome; D014766:Viremia / Q000188:drug therapy / Q000821:virology
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir; D000410:Alanine Transaminase; D000225:Adenine