Tenofovir plus entecavir combination therapy for chronic hepatitis B with nucleos(t)ide analogue failure

Authors : Bengü TATAR, Şükran KÖSE

Pages : 270-275

Doi:10.18621/eurj.645852

View : 10 | Download : 6

Publication Date : 2020-07-04

Article Type : Research Paper

Abstract :Objectives: Currently, both entecavir insert ignore into journalissuearticles values(ETV); and tenofovir insert ignore into journalissuearticles values(TDF); are recommended first-line therapy for chronic hepatitis B treatment due to good tolerance, lower side-effect profile and high genetic barrier. However, mutations that may develop in the polymerase gene during treatment may result treatment failure. In this study, we aimed to evaluate the efficacy and virologic response of ETV plus TDF combination therapy in chronic hepatitis B patients with suboptimal response to nucleosinsert ignore into journalissuearticles values(t);ide analogues insert ignore into journalissuearticles values(NAs); monotherapy. Methods: A total of 813 patients who were followed-up with the diagnosis of chronic hepatitis B and who were treated with TDF or ETV monotherapy were screened. Patients who had a partial or non response to monotherapy during at least 12 months and who was the presence of serum HBV-DNA levels ≥ 2000 IU/mL at the time of initiation of the ETV plus TDF combination therapy were included. Results: Ten insert ignore into journalissuearticles values(1.2%); patients insert ignore into journalissuearticles values(9 TDF, 1 ETV); were identified to have had partial response insert ignore into journalissuearticles values(50%); or breaktrough insert ignore into journalissuearticles values(40%); or virologic rebound insert ignore into journalissuearticles values(10%); to monotherapy. The median age was 36.8 years insert ignore into journalissuearticles values(range, 22-55 years);, and 5/10 insert ignore into journalissuearticles values(50%); patients were male. Of 10 patients, nine of achieved undetectable HBV-DNA insert ignore into journalissuearticles values(< 15 IU/mL); levels insert ignore into journalissuearticles values(50% of in 6 months and 90% of in 18 months); with combination therapy. One patient showed no response. Conclusions: Our results suggest that combination therapy is superior to the antiviral change in treatment failure with NAs. In addition, it is important to conduct HBV drug resistance analyzes to prevent false drug change in treatment. 
Keywords : Combination therapy, chronic hepatitis B, virologic response, entecavir, tenofovir