title: Viral suppression and cirrhosis regression with tenofovir disoproxil fumarate in Asians with chronic hepatitis B.
abstract: BACKGROUND
  Chronic hepatitis B (CHB) is a major public health concern, particularly in endemic areas like Asia-Pacific. Sustained virologic suppression correlates with regression of histologic fibrosis and cirrhosis.
  
  
  OBJECTIVE
  This study evaluated efficacy and safety of tenofovir disoproxil fumarate (TDF) in Asian patients through 240 weeks of treatment.
  
  
  METHODS
  Post hoc analysis of the Asian subpopulation from two phase 3 clinical studies was performed. Following a 48-week randomized, double-blind evaluation of once-daily TDF versus once-daily adefovir dipivoxil, open-label TDF for up to 240 weeks was evaluated. Patients with both baseline and week 240 liver biopsies were evaluated for histologic changes.
  
  
  RESULTS
  At baseline, 189/641 (29 %) patients randomized were Asian. Sixty-eight percent of Asian patients were male; 50 % were hepatitis B e antigen (HBeAg)-positive. At week 240, similar proportions of Asian (88 %) and non-Asian (87 %) patients demonstrated improvement in liver histology, and 19/22 (86 %) Asian patients with baseline cirrhosis were no longer cirrhotic. By modified intent-to-treat analysis, 74 % of Asian patients and 76 % of non-Asian patients had HBV DNA <400 copies/mL at the end of week 240 (P = 0.602). No differences were seen in HBeAg loss or seroconversion in Asian versus non-Asian patients. No Asian patient experienced hepatitis B surface antigen loss. Safety and tolerability of TDF through week 240, including changes in renal function and in hip/spine bone mineral density (from weeks 192 to 240), were comparable between Asian and non-Asian patients.
  
  
  CONCLUSIONS
  Long-term virologic and histologic efficacy and safety of TDF are comparable in Asian and non-Asian CHB patients.
authors.affiliation: Department of Medicine, Queens Medical Center, University of Hawaii at Manoa, 550 S. Beretania Street, POB III #405, Honolulu, HI, 96734, USA, naoky@hawaii.edu.
authors.forename: Naoky C
authors.initials: NC
authors.lastname: Tsai
authors.forename: Patrick
authors.initials: P
authors.lastname: Marcellin
authors.forename: Maria
authors.initials: M
authors.lastname: Buti
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Washington
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Lee
authors.forename: Sing
authors.initials: S
authors.lastname: Chan
authors.forename: Huy
authors.initials: H
authors.lastname: Trinh
authors.forename: John F
authors.initials: JF
authors.lastname: Flaherty
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Kitrinos
authors.forename: Phillip
authors.initials: P
authors.lastname: Dinh
authors.forename: Prista
authors.initials: P
authors.lastname: Charuworn
authors.forename: G Mani
authors.initials: GM
authors.lastname: Subramanian
authors.forename: Edward
authors.initials: E
authors.lastname: Gane
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004279:DNA, Viral / Q000032:analysis; D004311:Double-Blind Method; D005260:Female; D006515:Hepatitis B virus / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D057194:Intention to Treat Analysis; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012307:Risk Factors; D000068698:Tenofovir
chemical_list: D004279:DNA, Viral; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D000068698:Tenofovir; D000225:Adenine