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- 저자 : ( Fabien Zouli (검색결과 1 건)
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( Goh Eun Chung ),( Eun Ju Cho ),( Jeong-hoon Lee ),( Jeong-ju Yoo ),( Minjong Lee ),( Yuri Cho ),( Dong Hyeon Lee ),( Hwi Young Kim ),( Su Jong Yu ),( Yoon Jun Kim ),( Jung-hwan Yoon ),( Fabien Zouli 대한간학회 2017 Clinical and Molecular Hepatology(대한간학회지) Vol.23 No.1
Background/Aims: A recent study reported that entecavir had inferior efficacy in nucleos(t)ide analogue (NA)-experienced chronic hepatitis B (CHB) patients compared to NA-naive patients. We sought to compare the efficacy of tenofovir disoproxil fumarate (TDF) in NA-experienced and NA-naive CHB patients. Methods: We retrospectively enrolled 252 consecutive patients who had a serum hepatitis B virus (HBV) DNA level greater than 2,000 IU/mL at the initiation of TDF treatment and who received TDF for at least 6 months. Complete virologic suppression (CVS) was defined as undetectable serum HBV DNA. We generated a multivariate Cox proportional-hazard model to examine predictive factors that were independently associated with time to CVS. Results: The mean age of patients was 48.2 years, and the cohort included 181 NA-naive patients and 71 NA-experienced patients. The median duration of TDF treatment was 14.4 (interquartile range, 9.5-17.8) months. A total of 167 (92.3%) of 181 NA-naive patients achieved CVS, and 60 (84.5%) of 71 NA-exposed patients achieved CVS. Forty-nine (89.1%) of 55 patients who previously took an NA aside from adefovir and 11 (68.8%) of 16 adefovir-experienced patients achieved CVS. In multivariable analysis, previous adefovir exposure significantly influenced time to CVS (hazard ratio, 0.37; 95% confidence interval, 0.19-0.72; P=0.003), after adjusting for HBeAg positivity, baseline HBV DNA level and cirrhosis. Conclusions: Tenofovir had inferior efficacy in adefovir-experienced CHB patients compared to NA-naive patients. The response of patients with previous adefovir exposure to TDF monotherapy should be monitored closely. (Clin Mol Hepatol 2017;23:66-73)
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