title: Efficacy and safety of tenofovir-based rescue therapy for chronic hepatitis B patients with previous nucleo(s/t)ide treatment failure.
abstract: OBJECTIVE
  We investigated the efficacy and safety of tenofovir disoproxil fumarate (TDF)-based treatment in chronic hepatitis B (CHB) patients who failed previous antiviral therapies.
  
  
  METHODS
  Seventeen patients who failed to achieve virological responses during sequential antiviral treatments were included. The patients were treated with TDF monotherapy (four patients) or a combination of TDF and lamivudine (13 patients) for a median of 42 months. Hepatitis B virus (HBV) DNA and hepatitis B e antigen (HBeAg) were measured, and renal function was also monitored.
  
  
  RESULTS
  Prior to TDF therapy, 180 M, 204 I/V/S, 181 T/V, 236 T, and 184 L mutations were detected. After TDF therapy, the median HBV DNA level decreased from 4.6 log10 IU/mL to 2.0 log10 IU/mL and to 1.6 log10 IU/mL at 12 and 24 months, respectively. HBV DNA became undetectable (≤20 IU/mL) in 14.3%, 41.7%, and 100% of patients after 12, 24, and 48 months of treatment, respectively. HBeAg loss was observed in two patients. Viral breakthrough occurred in five patients who had skipped their medication. No significant changes in renal function were observed.
  
  
  CONCLUSIONS
  TDF-based rescue treatment is effective in reducing HBV DNA levels and is safe for patients with CHB who failed prior antiviral treatments. Patients' adherence to medication is related to viral rebound.
authors: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors: Cho I
authors: CI
authors: Lee
authors: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors: So Young
authors: SY
authors: Kwon
authors: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors: Jeong Han
authors: JH
authors: Kim
authors: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors: Won Hyeok
authors: WH
authors: Choe
authors: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors: Chang Hong
authors: CH
authors: Lee
authors: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors: Eileen L
authors: EL
authors: Yoon
authors: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors: Jong Eun
authors: JE
authors: Yeon
authors: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors: Kwan Soo
authors: KS
authors: Byun
authors: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
authors: Yun Soo
authors: YS
authors: Kim
authors: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
authors: Ju Hyun
authors: JH
authors: Kim
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D004279:DNA, Viral / Q000097:blood; D024882:Drug Resistance, Viral / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D000068698:Tenofovir; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D000068698:Tenofovir; D000225:Adenine
keywords: Antiviral agents; Hepatitis B; Resistance; Tenofovir; Treatment outcome