Clinical

Tenofovir plus emtricitabine shows efficacy in resistant HBV infection

Last Updated: 2006-12-29 16:00:21 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A switch from adefovir to tenofovir plus emtricitabine may achieve undetectable viral levels in chronic hepatitis B virus (HBV) infection when an adefovir-containing regimen fails, investigators at Mount Sinai School of Medicine in New York report.

In a study published in the December issue of the European Journal of Gastroenterology and Hepatology, Dr. Stephanie A. Santos and colleagues describe seven patients with chronic HBV infection who failed to achieve undetectable levels of HBV DNA on adefovir or an adefovir-containing regimen.

Patients were all HIV- seronegative. They had been on adefovir for a mean of ten months at enrollment and median HBV DNA was 430,000 copies/ml with a median fall in HBV DNA of 2.0 log10copies/ml.

Dr. Santos' team changed treatment to tenofovir, 300 mg daily, and emtricitabine, 200 mg daily.

After a median treatment duration of 23 months with tenofovir, the HBV DNA fall was 3.0 log10copies/ml.

All seven patients achieved undetectable HBV DNA levels with tenofovir. Anti-hepatitis B e seroconversion occurred in one patient.

There were no significant changes in serum creatinine levels and none of the patients reported serious adverse effects.

"Given the possibility of significant morbidity and mortality with hepatitis B, it is imperative that new treatment options be explored," the investigators point out. "It has been shown that lower levels of HBV DNA correlate with an improved histologic, biochemical and serologic response."

While adefovir is the treatment of choice for chronic HBV infection, resistance develops in more than one-quarter of patients, the authors write. The response in this series of patients to tenofovir after treatment failure with adefovir indicates that it may be an effective option for patients with resistant HBV infection.

Eur J Gastroenterol Hepatol 2006;18:1247-1253.