Chinese Hepatolgy ›› 2022, Vol. 27 ›› Issue (12): 1300-1304.

• Viral Hepatitis • Previous Articles     Next Articles

A study on the efficacy and safety of switching initial poor-responsive nucleoside analogues to Tenofovir treatment in chronic hepatitis B patients

CHEN Tong-tong1,2, FAN Rui-fang1, YANG Ya-xuan1, ZHANG Ye-qiong1, XU Wen-xiong1, PENG Liang1, LI Yang-mei1   

  1. 1. The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China;
    2. Hainan General Hospital,Haikou 570311, China
  • Received:2022-01-10 Published:2023-01-30
  • Contact: LI Yang-mei, Email:spice205@163.com

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Abstract: Objective To observe the efficacy and safety of switching poor virological responsive nucleoside analogues (NAs) to Tenofovir (TDF) treatment in chronic hepatitis B (CHB) patients.Methods One hundred and eight CHB patients were enrolled after screening. They were divided into the following three groups based on their drug switch regimes: ETV to ETV group (n=32), ETV to TDF group (n=30) and NON-ETV to TDF group (n=46). The differences of cumulative HBV DNA undetectable rate, HBV DNA quantification load and other viral indicators, alanine aminotransferase, serum creatinine and other biochemical parameters in each group at baseline and at each follow-up point were observed and compared.Results The quantitative logarithms of HBV DNA at week 24 were 2.0 (2.0-2.0) IU/mL in the ETV-to-TDF group compared with that of 2.0 (2.0-2.50) IU/mL in the ETV-to-ETV group (P=0.034). At week 24, the cumulative undetectable rate of HBV DNA in ETV to TDF group was 83.3%, which was significantly higher than that of 56.3% in ETV to ETV group (χ2=5.34, P=0.021). There was no significant difference in the duration of HBV DNA undetectable time between the two groups(24.8±3.57 vs. 36.4±5.35 weeks, P=0.124). The cumulative undetectable rates of HBV DNA at 24 and 48 weeks of the ETV to TDF group compared with those of the non-ETV to TDF group were 83.3% vs. 82.8% (P=0.935) and 90% vs. 93.5% (P=0.675), respectively, and the differences were not statistically significant. There was no statistical correlation between the course of ETV treatment within 48 to 96 weeks and the HBV DNA negative conversion time after switching to TDF (P=0.270). No virological breakthrough occurred in any of the patients. None of the patients had serious adverse reactions such as rhabdomyolysis.Conclusion TDF is an effective and safety treatment for patients with poor virological response to initial treatment with other nucleoside drugs. Switching to TDF therapy rather than continuing ETV therapy may promote HBV DNA negative conversion in patients with poor responsiveness to ETV treatment. The course of ETV treatment within 48 to 96 weeks may not affect the efficacy of switching to TDF treatment thereafter.

Key words: Chronic hepatitis B, Tenofovir, Entecavir, Poor responsiveness