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New approaches in the management of chronic hepatitis B: role of tenofovir.

Reijnders JG, LA Janssen H - Infect Drug Resist (2009)

Bottom Line: TDF was superior to adefovir dipivoxil (ADV) in both nucleos(t)ide-naïve HBeAg-positive and HBeAg-negative HBV patients, and appeared to be one of the most potent antiviral agents so far.In addition, several reports showed that TDF was also effective in the nucleos(t)ide-experienced population, although conflicting results have been presented concerning patients with genotypic resistance to ADV.As treatment with TDF may be associated with nephrotoxicity, all TDF-treated patients should be monitored for renal function at baseline and periodically thereafter.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, The Netherlands.

ABSTRACT
In the field of HIV management, tenofovir disoproxil fumarate (TDF) plays a pivotal role and has been demonstrated to be a safe and well-tolerated antiviral agent. Recent data showed the efficacy of TDF in the treatment of chronically hepatitis B virus (HBV)-infected patients. TDF was superior to adefovir dipivoxil (ADV) in both nucleos(t)ide-naïve HBeAg-positive and HBeAg-negative HBV patients, and appeared to be one of the most potent antiviral agents so far. In addition, several reports showed that TDF was also effective in the nucleos(t)ide-experienced population, although conflicting results have been presented concerning patients with genotypic resistance to ADV. TDF seems to have a good resistance profile as well. The rtA194T mutation in association with lamivudine resistance may confer resistance to TDF, although both in vivo and in vitro studies regarding this mutation demonstrate conflicting results. As treatment with TDF may be associated with nephrotoxicity, all TDF-treated patients should be monitored for renal function at baseline and periodically thereafter. While the relative roles of interferon vs nucleos(t)ide analogues (NA) as initial anti-HBV therapy remains unclear, TDF will probably become one of the key factors in HBV management both as first-choice NA for nucleos(t)ide-naïve patients and as rescue therapy for nucleos(t)ide-experienced patients.

No MeSH data available.


Related in: MedlinePlus

The natural of history of chronic hepatitis B virus infection.Abbreviations: HBV, chronic hepatitis B virus; HBeAg, hepatitis B e antigen; ALT, alanine aminotransferase.
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f1-idr-2-013: The natural of history of chronic hepatitis B virus infection.Abbreviations: HBV, chronic hepatitis B virus; HBeAg, hepatitis B e antigen; ALT, alanine aminotransferase.

Mentions: Hepatitis B has a complex natural history and causes a wide spectrum of disease. A chronic HBV infection is defined by presence of hepatitis B surface antigen (HBsAg) in serum for more than 6 months. The rate of progression from acute to chronic HBV infection is primarily determined by the age at infection, which can be up to 90% in the setting of perinatal transmission, but is still less than 5% for adult-acquired HBV infection.3,4 Figure 1 depicts the natural course of chronic HBV infection, although it should be recognized that not all patients go through all phases.


New approaches in the management of chronic hepatitis B: role of tenofovir.

Reijnders JG, LA Janssen H - Infect Drug Resist (2009)

The natural of history of chronic hepatitis B virus infection.Abbreviations: HBV, chronic hepatitis B virus; HBeAg, hepatitis B e antigen; ALT, alanine aminotransferase.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108728&req=5

f1-idr-2-013: The natural of history of chronic hepatitis B virus infection.Abbreviations: HBV, chronic hepatitis B virus; HBeAg, hepatitis B e antigen; ALT, alanine aminotransferase.
Mentions: Hepatitis B has a complex natural history and causes a wide spectrum of disease. A chronic HBV infection is defined by presence of hepatitis B surface antigen (HBsAg) in serum for more than 6 months. The rate of progression from acute to chronic HBV infection is primarily determined by the age at infection, which can be up to 90% in the setting of perinatal transmission, but is still less than 5% for adult-acquired HBV infection.3,4 Figure 1 depicts the natural course of chronic HBV infection, although it should be recognized that not all patients go through all phases.

Bottom Line: TDF was superior to adefovir dipivoxil (ADV) in both nucleos(t)ide-naïve HBeAg-positive and HBeAg-negative HBV patients, and appeared to be one of the most potent antiviral agents so far.In addition, several reports showed that TDF was also effective in the nucleos(t)ide-experienced population, although conflicting results have been presented concerning patients with genotypic resistance to ADV.As treatment with TDF may be associated with nephrotoxicity, all TDF-treated patients should be monitored for renal function at baseline and periodically thereafter.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, The Netherlands.

ABSTRACT
In the field of HIV management, tenofovir disoproxil fumarate (TDF) plays a pivotal role and has been demonstrated to be a safe and well-tolerated antiviral agent. Recent data showed the efficacy of TDF in the treatment of chronically hepatitis B virus (HBV)-infected patients. TDF was superior to adefovir dipivoxil (ADV) in both nucleos(t)ide-naïve HBeAg-positive and HBeAg-negative HBV patients, and appeared to be one of the most potent antiviral agents so far. In addition, several reports showed that TDF was also effective in the nucleos(t)ide-experienced population, although conflicting results have been presented concerning patients with genotypic resistance to ADV. TDF seems to have a good resistance profile as well. The rtA194T mutation in association with lamivudine resistance may confer resistance to TDF, although both in vivo and in vitro studies regarding this mutation demonstrate conflicting results. As treatment with TDF may be associated with nephrotoxicity, all TDF-treated patients should be monitored for renal function at baseline and periodically thereafter. While the relative roles of interferon vs nucleos(t)ide analogues (NA) as initial anti-HBV therapy remains unclear, TDF will probably become one of the key factors in HBV management both as first-choice NA for nucleos(t)ide-naïve patients and as rescue therapy for nucleos(t)ide-experienced patients.

No MeSH data available.


Related in: MedlinePlus