title: Efficacy of tenofovir disoproxil fumarate therapy in Chinese chronic hepatitis B patients after multiple antiviral failures.
abstract: OBJECTIVE
  In this prospective study, we aimed to evaluate the efficacy and safety of tenofovir disoproxil fumarate (TDF) in Chinese chronic hepatitis B (CHB) patients after multiple nucleoside/nucleotide analog (NA) treatment failures.
  
  
  METHODS
  A total of 115 Chinese CHB patients with suboptimal response to two or more NA treatments were included in this study. All patients were changed to TDF (300 mg/day, oral administration) antiviral treatment for at least 72 weeks. Hepatitis B virus (HBV) polymerase (P) gene mutation screening for each patient was performed. In addition, virological, biochemical responses and estimated glomerular filtration rate (eGFR) of each patient at weeks 12, 24, 48 and 72 of TDF treatment were evaluated.
  
  
  RESULTS
  Seventy-six out of 115 patients had drug-resistance mutations (R(+) ), including 27 with adefovir (ADV)-associated mutations (35.5%) and 49 with lamivudine (LMV)-associated mutations (64.5%). For all included patients, complete viral response (CVR) of HBV DNA (<100 IU/mL) was 57.4%, 69.6%, 74.8% and 86.1% at weeks 12, 24, 48 and 72 of TDF treatment, respectively. Alanine aminotransferase normalization and hepatitis B e-antigen seroclearance occurred in 77.3% and 23.2%, respectively, after 72-week TDF treatment. CVR at weeks 12, 24 and 48 was observed more commonly in patients with baseline HBV DNA of less than 10(6)  IU/mL. There was no significant reduction of eGFR induced by the TDF treatment.
  
  
  CONCLUSIONS
  Seventy-two-week treatment with TDF in Chinese CHB patients with previously multiple NA treatment failures exhibited effective and safe outcomes, which were independent of baseline mutations conferring ADV or LMV resistance.
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Yingxia
authors.initials: Y
authors.lastname: Liu
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zeng
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Guoliang
authors.initials: G
authors.lastname: Zhang
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Simin
authors.initials: S
authors.lastname: Yao
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Li
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Deng
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Rongrong
authors.initials: R
authors.lastname: Zou
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.
authors.forename: Shaxi
authors.initials: S
authors.lastname: Li
authors.affiliation: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.|Department of Immunobiology, Institute of Tissue Transplantation and Immunology, Jinan University, Guangzhou, China.|Department of Anatomy, The University of Hong Kong, Hong Kong, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Xiao
keywords: Chinese; chronic hepatitis B; hepatitis B virus P gene mutation; tenofovir