J 2014

Randomized Comparison of Tenofovir Disoproxil Fumarate vs Emtricitabine and Tenofovir Disoproxil Fumarate in Patients With Lamivudine-Resistant Chronic Hepatitis B

FUNG, Scott; Peter KWAN; Milotka FABRI; Andrzej HORBAN; Mijomir PELEMIS et al.

Základní údaje

Originální název

Randomized Comparison of Tenofovir Disoproxil Fumarate vs Emtricitabine and Tenofovir Disoproxil Fumarate in Patients With Lamivudine-Resistant Chronic Hepatitis B

Autoři

FUNG, Scott; Peter KWAN; Milotka FABRI; Andrzej HORBAN; Mijomir PELEMIS; Hie-Won HANN; Selim GUREL; Florin A. CARUNTU; John F. FLAHERTY; Benedetta MASSETTO; Phillip DINH; Amoreena CORSA; G. Mani SUBRAMANIAN; John G. MCHUTCHISON; Petr HUSA a Edward GANE

Vydání

Gastroenterology, Philadelphia, W B Saunders co-Elsevier Inc, 2014, 0016-5085

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30300 3.3 Health sciences

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 16.716

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/14:00075497

Organizační jednotka

Lékařská fakulta

EID Scopus

Klíčová slova anglicky

HBV DNA; Hepatitis B e Antigen; Renal Function; Viral Suppression

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 16. 5. 2014 17:16, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

BACKGROUND & AIMS: Tenofovir disoproxil fumarate (TDF) is active against lamivudine-resistant hepatitis B virus (HBV) infection, but data to support its clinical efficacy in this setting are limited. METHODS: In a prospective, double-blind, 96-week trial, patients were randomly assigned (1:1) to groups given TDF (300 mg, n = 141) or a combination of emtricitabine (FTC, 200 mg; n 139) and TDF (300 mg, FTC/TDF). Patients were hepatitis B e antigen (HBeAg) - positive or HBeAg-negative, with levels of HBV DNA >= 3 log10 IU/mL and lamivudine resistance mutations (HBV polymerase or reverse transcriptase amino acid substitutions rtM204I/V +/- rtL180M by INNO-LiPA Multi-DR v3; Innogenetics, Inc, Alpharetta, GA). The primary end point was proportion with HBV DNA <69 IU/mL (Roche COBAS Taqman assay; Roche Molecular Systems, Inc, Pleasanton, CA). RESULTS: Patient groups were well matched for demographic and disease characteristics, including region (60% from Europe), HBV genotype (45% genotype D), HBeAg status (47% HBeAg-positive), and duration of lamivudine treatment (mean, 3.8 years). At week 96 of treatment, 89.4% of patients in the TDF group and 86.3% in the FTC/TDF group had levels of HBV DNA <69 IU/mL (P = .43). HBeAg loss and seroconversion did not differ between groups; only 1 patient (0.7%) in the FTC/TDF group lost hepatitis B surface antigen. Treatment was well tolerated; confirmed renal events (creatinine increase of >= 0.5 mg/dL [>44 umol/L], creatinine clearance <50 mL/min, or level of PO4 <2 mg/dL [<0.65 mmol/L]) were generally mild and infrequent (<1%). Small reductions (<2%) in mean bone mineral density of hip and spine were detected by dual-energy x-ray absorptiometry in both groups. No TDF resistance developed through 96 weeks of treatment. CONCLUSIONS: TDF alone is safe and effective for treatment of patients with lamivudine-resistant, chronic HBV infection. Clinical Trials.gov No, NCT00737568.