Tenofovir disoproxil fumarate has a substantial efficacy against multidrug-resistant strains of hepatitis B virus

Background & Aims To evaluate the efficacy of tenofovir in chronic hepatitis B (CHB) patients with adefovir resistance (ADF‐R) and suboptimal response to adefovir (ADF‐S). Methods Nucleos(t)ide analogue (NA)‐naïve patients and patients with previous adefovir failure receiving tenofovir therapy f...

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Veröffentlicht in:Liver international 2015-10, Vol.35 (10), p.2265-2274
Hauptverfasser: Baran, Bulent, Soyer, Ozlem Mutluay, Ormeci, Asli Cifcibasi, Gokturk, Suut, Evirgen, Sami, Akyuz, Filiz, Karaca, Cetin, Demir, Kadir, Besisik, Fatih, Onel, Derya, Gulluoglu, Mine, Badur, Selim, Kaymakoglu, Sabahattin
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container_end_page 2274
container_issue 10
container_start_page 2265
container_title Liver international
container_volume 35
creator Baran, Bulent
Soyer, Ozlem Mutluay
Ormeci, Asli Cifcibasi
Gokturk, Suut
Evirgen, Sami
Akyuz, Filiz
Karaca, Cetin
Demir, Kadir
Besisik, Fatih
Onel, Derya
Gulluoglu, Mine
Badur, Selim
Kaymakoglu, Sabahattin
description Background & Aims To evaluate the efficacy of tenofovir in chronic hepatitis B (CHB) patients with adefovir resistance (ADF‐R) and suboptimal response to adefovir (ADF‐S). Methods Nucleos(t)ide analogue (NA)‐naïve patients and patients with previous adefovir failure receiving tenofovir therapy for at least 6 months were included in the study. Biochemical and virological tests were obtained at baseline and 3‐month intervals in the first year and every 6 months thereafter. The primary outcome measure was complete virological response (CVR) (HBVDNA 
doi_str_mv 10.1111/liv.12831
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Methods Nucleos(t)ide analogue (NA)‐naïve patients and patients with previous adefovir failure receiving tenofovir therapy for at least 6 months were included in the study. Biochemical and virological tests were obtained at baseline and 3‐month intervals in the first year and every 6 months thereafter. The primary outcome measure was complete virological response (CVR) (HBVDNA &lt; 20 IU/ml). CVR rates were calculated by Kaplan–Meier analysis, and a multivariate Cox proportional hazard model was generated to find out factors independently associated with CVR. Results A total of 165 patients (118 men, mean age 42 ± 12, 64 HBeAg+) were included in the study. There were 105 patients in NA‐naïve, 32 patients in ADF‐S and 28 patients in ADF‐R groups. All patients in the ADF‐R group had multidrug resistance patterns. Mean duration of tenofovir treatment was 29 ± 14 months. CVR rates in NA‐naïve, ADF‐S and ADF‐R groups were 65% vs. 75% vs. 58% at 12th month, 77% vs. 87% vs. 79% at 24th month and 83% vs. 94% vs. 79% at 36th month respectively. According to multivariate Cox regression model, HBeAg positivity (HR = 0.56, 95%CI 0.36–0.86, P = 0.008), high baseline HBVDNA level (HR = 0.64, 95%CI 0.55–0.74, P &lt; 0.001) and ADF‐R (HR = 0.47, 95%CI 0.28–0.81, P = 0.006) were independent predictors for CVR. Seven patients encountered mild renal dysfunction and were managed by dose adjustments. Conclusion CVR rates during the follow‐up show that tenofovir has a decreased, yet still potent in vivo efficacy against multidrug‐resistant strains of HBV.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.12831</identifier><identifier>PMID: 25800974</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>adefovir failure ; Adolescent ; Adult ; Aged ; Alanine Transaminase ; Antiviral Agents - administration &amp; dosage ; chronic hepatitis B ; DNA, Viral ; Drug Resistance, Viral ; Female ; genotypic resistance ; Hepatitis B e Antigens - blood ; Hepatitis B virus - drug effects ; Hepatitis B virus - genetics ; Hepatitis B, Chronic - drug therapy ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Tenofovir - administration &amp; dosage ; tenofovir disoproxil fumarate ; Treatment Outcome ; Viral Load ; Young Adult</subject><ispartof>Liver international, 2015-10, Vol.35 (10), p.2265-2274</ispartof><rights>2015 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd</rights><rights>2015 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4331-c0098847c54f09b240b08caf87d6dd64b087c051049da940640163de00af94ed3</citedby><cites>FETCH-LOGICAL-c4331-c0098847c54f09b240b08caf87d6dd64b087c051049da940640163de00af94ed3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fliv.12831$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.12831$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25800974$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baran, Bulent</creatorcontrib><creatorcontrib>Soyer, Ozlem Mutluay</creatorcontrib><creatorcontrib>Ormeci, Asli Cifcibasi</creatorcontrib><creatorcontrib>Gokturk, Suut</creatorcontrib><creatorcontrib>Evirgen, Sami</creatorcontrib><creatorcontrib>Akyuz, Filiz</creatorcontrib><creatorcontrib>Karaca, Cetin</creatorcontrib><creatorcontrib>Demir, Kadir</creatorcontrib><creatorcontrib>Besisik, Fatih</creatorcontrib><creatorcontrib>Onel, Derya</creatorcontrib><creatorcontrib>Gulluoglu, Mine</creatorcontrib><creatorcontrib>Badur, Selim</creatorcontrib><creatorcontrib>Kaymakoglu, Sabahattin</creatorcontrib><title>Tenofovir disoproxil fumarate has a substantial efficacy against multidrug-resistant strains of hepatitis B virus</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>Background &amp; Aims To evaluate the efficacy of tenofovir in chronic hepatitis B (CHB) patients with adefovir resistance (ADF‐R) and suboptimal response to adefovir (ADF‐S). Methods Nucleos(t)ide analogue (NA)‐naïve patients and patients with previous adefovir failure receiving tenofovir therapy for at least 6 months were included in the study. Biochemical and virological tests were obtained at baseline and 3‐month intervals in the first year and every 6 months thereafter. The primary outcome measure was complete virological response (CVR) (HBVDNA &lt; 20 IU/ml). CVR rates were calculated by Kaplan–Meier analysis, and a multivariate Cox proportional hazard model was generated to find out factors independently associated with CVR. Results A total of 165 patients (118 men, mean age 42 ± 12, 64 HBeAg+) were included in the study. There were 105 patients in NA‐naïve, 32 patients in ADF‐S and 28 patients in ADF‐R groups. All patients in the ADF‐R group had multidrug resistance patterns. Mean duration of tenofovir treatment was 29 ± 14 months. CVR rates in NA‐naïve, ADF‐S and ADF‐R groups were 65% vs. 75% vs. 58% at 12th month, 77% vs. 87% vs. 79% at 24th month and 83% vs. 94% vs. 79% at 36th month respectively. According to multivariate Cox regression model, HBeAg positivity (HR = 0.56, 95%CI 0.36–0.86, P = 0.008), high baseline HBVDNA level (HR = 0.64, 95%CI 0.55–0.74, P &lt; 0.001) and ADF‐R (HR = 0.47, 95%CI 0.28–0.81, P = 0.006) were independent predictors for CVR. Seven patients encountered mild renal dysfunction and were managed by dose adjustments. Conclusion CVR rates during the follow‐up show that tenofovir has a decreased, yet still potent in vivo efficacy against multidrug‐resistant strains of HBV.</description><subject>adefovir failure</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Alanine Transaminase</subject><subject>Antiviral Agents - administration &amp; dosage</subject><subject>chronic hepatitis B</subject><subject>DNA, Viral</subject><subject>Drug Resistance, Viral</subject><subject>Female</subject><subject>genotypic resistance</subject><subject>Hepatitis B e Antigens - blood</subject><subject>Hepatitis B virus - drug effects</subject><subject>Hepatitis B virus - genetics</subject><subject>Hepatitis B, Chronic - drug therapy</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Proportional Hazards Models</subject><subject>Tenofovir - administration &amp; dosage</subject><subject>tenofovir disoproxil fumarate</subject><subject>Treatment Outcome</subject><subject>Viral Load</subject><subject>Young Adult</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtPGzEURi3Uikdg0T9QedkuhlyPPeOZZYsojRS1IF4SG8vxA9xOMsHXE8i_ryGQXb2xr3zud-1DyCcGxyyvcRdWx6xsONsh-0zIpuAlZx-255LvkQPEPwCsbSu2S_bKqgFopdgnj1du0ft-FSK1Aftl7J9DR_0w11EnRx80Uk1xmGHSixR0R533wWizpvpehwUmOh-6FGwc7ovoMLxyFFN8uaS9pw9uqVNIAel3mqcMeEg-et2hO3rbR-T6x-nVyc9i-vtscvJtWhjBOStMfmDTCGkq4aGdlQJm0BjtG2lra2uRK2mgYiBaq1sBtQBWc-sAtG-Fs3xEvmxy858eB4dJzQMa13V64foBFZNMijyAQUa_blATe8TovFrGkA2sFQP1Ylhlw-rVcGY_v8UOs7mzW_JdaQbGG-ApdG79_yQ1ndy8RxabjmzPPW87dPyrasllpW5_nanL84tbuCsv1A3_B-ASlkY</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>Baran, Bulent</creator><creator>Soyer, Ozlem Mutluay</creator><creator>Ormeci, Asli Cifcibasi</creator><creator>Gokturk, Suut</creator><creator>Evirgen, Sami</creator><creator>Akyuz, Filiz</creator><creator>Karaca, Cetin</creator><creator>Demir, Kadir</creator><creator>Besisik, Fatih</creator><creator>Onel, Derya</creator><creator>Gulluoglu, Mine</creator><creator>Badur, Selim</creator><creator>Kaymakoglu, Sabahattin</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201510</creationdate><title>Tenofovir disoproxil fumarate has a substantial efficacy against multidrug-resistant strains of hepatitis B virus</title><author>Baran, Bulent ; Soyer, Ozlem Mutluay ; Ormeci, Asli Cifcibasi ; Gokturk, Suut ; Evirgen, Sami ; Akyuz, Filiz ; Karaca, Cetin ; Demir, Kadir ; Besisik, Fatih ; Onel, Derya ; Gulluoglu, Mine ; Badur, Selim ; Kaymakoglu, Sabahattin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4331-c0098847c54f09b240b08caf87d6dd64b087c051049da940640163de00af94ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>adefovir failure</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Alanine Transaminase</topic><topic>Antiviral Agents - administration &amp; dosage</topic><topic>chronic hepatitis B</topic><topic>DNA, Viral</topic><topic>Drug Resistance, Viral</topic><topic>Female</topic><topic>genotypic resistance</topic><topic>Hepatitis B e Antigens - blood</topic><topic>Hepatitis B virus - drug effects</topic><topic>Hepatitis B virus - genetics</topic><topic>Hepatitis B, Chronic - drug therapy</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Proportional Hazards Models</topic><topic>Tenofovir - administration &amp; dosage</topic><topic>tenofovir disoproxil fumarate</topic><topic>Treatment Outcome</topic><topic>Viral Load</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baran, Bulent</creatorcontrib><creatorcontrib>Soyer, Ozlem Mutluay</creatorcontrib><creatorcontrib>Ormeci, Asli Cifcibasi</creatorcontrib><creatorcontrib>Gokturk, Suut</creatorcontrib><creatorcontrib>Evirgen, Sami</creatorcontrib><creatorcontrib>Akyuz, Filiz</creatorcontrib><creatorcontrib>Karaca, Cetin</creatorcontrib><creatorcontrib>Demir, Kadir</creatorcontrib><creatorcontrib>Besisik, Fatih</creatorcontrib><creatorcontrib>Onel, Derya</creatorcontrib><creatorcontrib>Gulluoglu, Mine</creatorcontrib><creatorcontrib>Badur, Selim</creatorcontrib><creatorcontrib>Kaymakoglu, Sabahattin</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baran, Bulent</au><au>Soyer, Ozlem Mutluay</au><au>Ormeci, Asli Cifcibasi</au><au>Gokturk, Suut</au><au>Evirgen, Sami</au><au>Akyuz, Filiz</au><au>Karaca, Cetin</au><au>Demir, Kadir</au><au>Besisik, Fatih</au><au>Onel, Derya</au><au>Gulluoglu, Mine</au><au>Badur, Selim</au><au>Kaymakoglu, Sabahattin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tenofovir disoproxil fumarate has a substantial efficacy against multidrug-resistant strains of hepatitis B virus</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2015-10</date><risdate>2015</risdate><volume>35</volume><issue>10</issue><spage>2265</spage><epage>2274</epage><pages>2265-2274</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background &amp; Aims To evaluate the efficacy of tenofovir in chronic hepatitis B (CHB) patients with adefovir resistance (ADF‐R) and suboptimal response to adefovir (ADF‐S). Methods Nucleos(t)ide analogue (NA)‐naïve patients and patients with previous adefovir failure receiving tenofovir therapy for at least 6 months were included in the study. Biochemical and virological tests were obtained at baseline and 3‐month intervals in the first year and every 6 months thereafter. The primary outcome measure was complete virological response (CVR) (HBVDNA &lt; 20 IU/ml). CVR rates were calculated by Kaplan–Meier analysis, and a multivariate Cox proportional hazard model was generated to find out factors independently associated with CVR. Results A total of 165 patients (118 men, mean age 42 ± 12, 64 HBeAg+) were included in the study. There were 105 patients in NA‐naïve, 32 patients in ADF‐S and 28 patients in ADF‐R groups. All patients in the ADF‐R group had multidrug resistance patterns. Mean duration of tenofovir treatment was 29 ± 14 months. CVR rates in NA‐naïve, ADF‐S and ADF‐R groups were 65% vs. 75% vs. 58% at 12th month, 77% vs. 87% vs. 79% at 24th month and 83% vs. 94% vs. 79% at 36th month respectively. According to multivariate Cox regression model, HBeAg positivity (HR = 0.56, 95%CI 0.36–0.86, P = 0.008), high baseline HBVDNA level (HR = 0.64, 95%CI 0.55–0.74, P &lt; 0.001) and ADF‐R (HR = 0.47, 95%CI 0.28–0.81, P = 0.006) were independent predictors for CVR. Seven patients encountered mild renal dysfunction and were managed by dose adjustments. Conclusion CVR rates during the follow‐up show that tenofovir has a decreased, yet still potent in vivo efficacy against multidrug‐resistant strains of HBV.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25800974</pmid><doi>10.1111/liv.12831</doi><tpages>10</tpages></addata></record>
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source MEDLINE; Access via Wiley Online Library
subjects adefovir failure
Adolescent
Adult
Aged
Alanine Transaminase
Antiviral Agents - administration & dosage
chronic hepatitis B
DNA, Viral
Drug Resistance, Viral
Female
genotypic resistance
Hepatitis B e Antigens - blood
Hepatitis B virus - drug effects
Hepatitis B virus - genetics
Hepatitis B, Chronic - drug therapy
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Tenofovir - administration & dosage
tenofovir disoproxil fumarate
Treatment Outcome
Viral Load
Young Adult
title Tenofovir disoproxil fumarate has a substantial efficacy against multidrug-resistant strains of hepatitis B virus
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