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Lin CY, Sun WC, Lu CM, Chen WC, Tsay FW, Tsai TJ, Kuo FY, Tsai WL. Entecavir vs. tenofovir disoproxil fumarate in the treatment of chronic hepatitis B patients with severe acute exacerbation. Eur J Gastroenterol Hepatol 2024; 36:1113-1118. [PMID: 38973530 DOI: 10.1097/meg.0000000000002709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
BACKGROUND The efficacy of different nucleos(t)ide analogs in the treatment of chronic hepatitis B virus (CHB) with severe acute exacerbation (SAE) remained unclear. Thus, this study aimed to compare the short-term efficacy of tenofovir disoproxil fumarate (TDF) and entecavir (ETV) in patients having CHB with SAE. METHODS We analyzed consecutive patients with treatment-naive CHB receiving TDF (n = 36) or ETV (n = 65) for SAE. The primary endpoint was overall mortality or receipt of liver transplantation (LT) by 24 weeks. The secondary endpoints are the comparison of ETV vs. TDF influences on renal function and virological and biochemical responses at 4, 12, 24, and 48 weeks. RESULTS The baseline characteristics were comparable between the two groups. By 24 weeks, 8 (22%) patients in the TDF group and 10 (15%) patients in the ETV group had either died (n = 15) or received LT (n = 3) ( P = 0.367). Cox-regression multivariate analysis revealed age ( P = 0.003), baseline international normalized ratio of prothrombin time ( P = 0.024), and early presence of hepatic encephalopathy ( P = 0.003) as independent factors associated with mortality or LT. The two groups of patients achieved comparable biochemical and virological responses at 48 weeks. No significant difference was found in the estimated glomerular filtration rate (eGFR) between the TDF and the ETV groups. However, a significant reduction in the eGFR at 48 weeks, as compared with the baseline, was found in each group. CONCLUSION TDF and ETV achieved similar short-term clinical outcomes and treatment responses in CHB patients with SAE.
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Affiliation(s)
- Chih-Yang Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Wei-Chih Sun
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital
| | - Chia-Ming Lu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital
| | - Wen-Chi Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital
| | - Feng-Woei Tsay
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital
| | - Tzun-Jiun Tsai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital
| | - Feng-Yu Kuo
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Wei-Lun Tsai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of General Internal Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Huynh T, Bui DM, Zhou TX, Hu KQ. Improvement of hepatic fibrosis after tenofovir disoproxil fumarate switching to tenofovir alafenamide for three years. World J Hepatol 2024; 16:1009-1017. [PMID: 39086529 PMCID: PMC11287611 DOI: 10.4254/wjh.v16.i7.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/03/2024] [Accepted: 06/27/2024] [Indexed: 07/26/2024] Open
Abstract
BACKGROUND Both tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) are the first-line treatments for chronic hepatitis B (CHB). We have showed switching from TDF to TAF for 96 weeks resulted in further alanine aminotransferase (ALT) improvement, but data remain lacking on the long-term benefits of TDF switching to TAF on hepatic fibrosis. AIM To assess the benefits of TDF switching to TAF for 3 years on ALT, aspartate aminotransferase (AST), and hepatic fibrosis improvement in patients with CHB. METHODS A single center retrospective study on 53 patients with CHB who were initially treated with TDF, then switched to TAF to determine dynamic patterns of ALT, AST, AST to platelet ratio index (APRI), fibrosis-4 (FIB-4) scores, and shear wave elastography (SWE) reading improvement at switching week 144, and the associated factors. RESULTS The mean age was 55 (28-80); 45.3%, males; 15.1%, clinical cirrhosis; mean baseline ALT, 24.8; AST, 25.7 U/L; APRI, 0.37; and FIB-4, 1.66. After 144 weeks TDF switching to TAF, mean ALT and AST were reduced to 19.7 and 21, respectively. From baseline to switching week 144, the rates of ALT and AST < 35 (male)/25 (female) and < 30 (male)/19 (female) were persistently increased; hepatic fibrosis was also improved by APRI < 0.5, from 79.2% to 96.2%; FIB-4 < 1.45, from 52.8% to 58.5%, respectively; mean APRI was reduced to 0.27; FIB-4, to 1.38; and mean SWE reading, from 7.05 to 6.30 kPa after a mean of 109 weeks switching. The renal function was stable and the frequency of patients with glomerular filtration rate > 60 mL/min was increased from 86.5% at baseline to 88.2% at switching week 144. CONCLUSION Our data confirmed that switching from TDF to TAF for 3 years results in not only persistent ALT/AST improvement, but also hepatic fibrosis improvement by APRI, FIB-4 scores, as well as SWE reading, the important clinical benefits of long-term hepatitis B virus antiviral treatment with TAF.
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Affiliation(s)
- Tung Huynh
- Department of Pharmacy, University of California Irvine Medical Center, Orange, CA 92868, United States
| | | | - Tina Xiwen Zhou
- Chicago Medical School at Rosalind Franklin University, North Chicago, IL 60064, United States
| | - Ke-Qin Hu
- Division of Gastroenterology and Hepatology, University of California Irvine, School of Medicine, Orange, CA 92868, United States.
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Cavalera S, Serra T, Abad-Fuentes A, Mercader JV, Abad-Somovilla A, Nardo FD, D'Avolio A, De Nicolò A, Testa V, Chiarello M, Baggiani C, Anfossi L. Development and In-House Validation of an Enzyme-Linked Immunosorbent Assay and a Lateral Flow Immunoassay for the Dosage of Tenofovir in Human Saliva. BIOSENSORS 2023; 13:667. [PMID: 37367032 DOI: 10.3390/bios13060667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/28/2023]
Abstract
Highly active antiretroviral therapy (HAART) includes very potent drugs that are often characterized by high toxicity. Tenofovir (TFV) is a widely used drug prescribed mainly for pre-exposure prophylaxis (PreP) and the treatment of human immunodeficiency virus (HIV). The therapeutic range of TFV is narrow, and adverse effects occur with both underdose and overdose. The main factor contributing to therapeutic failure is the improper management of TFV, which may be caused by low compliance or patient variability. An important tool to prevent inappropriate administration is therapeutic drug monitoring (TDM) of compliance-relevant concentrations (ARCs) of TFV. TDM is performed routinely using time-consuming and expensive chromatographic methods coupled with mass spectrometry. Immunoassays, such as enzyme-linked immunosorbent assays (ELISAs) and lateral flow immunoassays (LFIAs), are based on antibody-antigen specific recognition and represent key tools for real-time quantitative and qualitative screening for point-of-care testing (POCT). Since saliva is a non-invasive and non-infectious biological sample, it is well-suited for TDM. However, saliva is expected to have a very low ARC for TFV, so tests with high sensitivity are required. Here, we have developed and validated a highly sensitive ELISA (IC50 1.2 ng/mL, dynamic range 0.4-10 ng/mL) that allows the quantification of TFV in saliva at ARCs and an extremely sensitive LFIA (visual LOD 0.5 ng/mL) that is able to distinguish between optimal and suboptimal ARCs of TFV in untreated saliva.
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Affiliation(s)
- Simone Cavalera
- Department of Chemistry, University of Turin, 10125 Turin, Italy
| | - Thea Serra
- Department of Chemistry, University of Turin, 10125 Turin, Italy
| | - Antonio Abad-Fuentes
- Institute of Agricultural Chemistry and Food Technology, Spanish Council for Scientific Research (IATA-CSIC), Paterna, 46980 Valencia, Spain
| | - Josep V Mercader
- Institute of Agricultural Chemistry and Food Technology, Spanish Council for Scientific Research (IATA-CSIC), Paterna, 46980 Valencia, Spain
| | - Antonio Abad-Somovilla
- Department of Organic Chemistry, University of Valencia, Burjassot, 46100 Valencia, Spain
| | - Fabio Di Nardo
- Department of Chemistry, University of Turin, 10125 Turin, Italy
| | - Antonio D'Avolio
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Amedeo De Nicolò
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Valentina Testa
- Department of Chemistry, University of Turin, 10125 Turin, Italy
| | - Matteo Chiarello
- Department of Chemistry, University of Turin, 10125 Turin, Italy
| | - Claudio Baggiani
- Department of Chemistry, University of Turin, 10125 Turin, Italy
| | - Laura Anfossi
- Department of Chemistry, University of Turin, 10125 Turin, Italy
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Shahab S, Sheikhi M, Khancheuski M, Yahyaei H, Almodarresiyeh HA, Kaviani S. DFT, molecular docking and ADME prediction of tenofovir drug as a promising therapeutic inhibitor of SARS-CoV-2 Mpro. MAIN GROUP CHEMISTRY 2022. [DOI: 10.3233/mgc-220046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the present work, at first, DFT calculations were carried out to study the molecular structure of the tenofovir at B3LYP/MidiX level of theory and in the water as solvent. The HOMO/LUMO molecular orbitals, excitation energies and oscillator strengths of investigated drug were also calculated and presented. NBO analysis was performed to illustrate the intramolecular rehybridization and electron density delocalization. In the following, a molecular docking study was performed for screening of effective available tenofovir drug which may act as an efficient inhibitor for the SARS-CoV-2 Mpro. The binding energy value showed a good binding affinity between the tenofovir and SARS-CoV-2 Mpro with binding energy of-47.206 kcal/mol. Therefore, tenofovir can be used for possible application against the SARS-CoV-2 Mpro.
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Affiliation(s)
- Siyamak Shahab
- Belarusian State University, ISEI BSU, Minsk, Republic of Belarus
- Institute of Physical Organic Chemistry, National Academy of Sciences of Belarus, 13 Surganov Str., Minsk
- Institute of Chemistry of New Materials, National Academy of Sciences of Belarus, 36 Skarina Str., Minsk
| | | | | | - Hooriye Yahyaei
- Department of Chemistry, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | | | - Sadegh Kaviani
- Department of Chemistry, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran
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Role of plasmatic and urinary concentration of tenofovir disoproxil fumarate in a cohort of patients affected by chronic hepatitis B. Arch Virol 2022; 167:1669-1674. [DOI: 10.1007/s00705-022-05466-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/26/2022] [Indexed: 11/25/2022]
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Li X, Tan XY, Cui XJ, Yang M, Chen C, Chen XY. Pharmacokinetics of Tenofovir Alafenamide Fumarate and Tenofovir in the Chinese People: Effects of Non-Genetic Factors and Genetic Variations. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2021; 14:1315-1329. [PMID: 34703277 PMCID: PMC8525415 DOI: 10.2147/pgpm.s329690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/28/2021] [Indexed: 01/05/2023]
Abstract
Background Tenofovir alafenamide fumarate (TAF) was approved for HBV treatment in China in 2018. Despite higher antiviral efficacy and less impact on renal function and bone mineral density, the pharmacokinetic profiles of TAF are highly variable. The objectives of this study were to investigate the pharmacokinetics of TAF in the Chinese population and explore the associations between TAF and genetic polymorphisms and non-genetic factors. Patients and Methods A total of 64 healthy Chinese subjects aged 18~65 years old were planned to enroll. According to the dietary intake status, the subjects were divided into two groups (n = 32 per group). The concentrations of TAF and tenofovir were measured by HPLC-MS/MS, and the single-nucleotide polymorphisms were analyzed by MALDI-TOF MS. Results All the enrolled participants (18–35 years) completed the clinical trial study. Similar to the results reported in other ethnic populations, the pharmacokinetic profiles of TAF and tenofovir were highly variable in the Chinese people, and the HFHC diet can significantly increase the systemic exposure of TAF. We determined both HFHC diet and rs7311358 (SLCO1B3) genotypes were independently associated with TAF AUC0-t, while HFHC diet, age and rs3740066 (ABCC2) variants were predictive of t1/2 of tenofovir (P < 0.05). The subjects with the AA genotype in rs7311358 had significantly higher TAF AUC0-t values (1.15 times) than those with a G allele, and the t1/2 of tenofovir in the rs3740066 TT genotype group was 1.23 times longer than that of CC genotype group. Furthermore, there was a trend of higher TAF AUC and shorter tenofovir t1/2 for the rs2032582 (ABCB1) T allele and rs3742106 (ABCC4) CC variant, respectively, although not statistically significant in the multiple linear regression analysis. Conclusion This study provided new evidence to suggest a critical link between both genetic and non-genetic factors and TAF pharmacokinetics in the Chinese people.
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Affiliation(s)
- Xue Li
- Phase I Clinical Research Laboratory of Shanghai LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Xin-Yi Tan
- Department of Rheumatology of Shanghai LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Xue-Jun Cui
- Institute of Spinal Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Ming Yang
- Phase I Clinical Research Laboratory of Shanghai LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Chao Chen
- Phase I Clinical Research Laboratory of Shanghai LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Xiao-Yun Chen
- Department of Rheumatology of Shanghai LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
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Tsai E. Review of Current and Potential Treatments for Chronic Hepatitis B Virus Infection. Gastroenterol Hepatol (N Y) 2021; 17:367-376. [PMID: 34602899 PMCID: PMC8475260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Chronic hepatitis B virus (HBV) infection remains a major global health burden. Millions of people are at risk for complications of chronic HBV infection, despite the widespread availability of an effective prophylactic vaccine. The current available treatments for HBV infection-interferon and nucleos(t)ide analogues-are effective at suppressing viral replication and decreasing the risk of cirrhosis. However, these treatments have a number of limitations, creating the need for alternative therapeutic agents. Recent advances in drug therapy have heralded a new horizon of novel therapeutic approaches for chronic HBV infection, with several promising antiviral and immunomodulatory agents currently in preclinical or clinical testing. This article reviews the current landscape of HBV treatments and highlights the most recent therapeutic strategies designed to directly target HBV or to improve immune response during chronic infection.
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Affiliation(s)
- Eugenia Tsai
- Texas Liver Institute and UT Health San Antonio, San Antonio, Texas
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8
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Li B, Liu Z, Liu X, Liu D, Duan M, Gu Y, Liu Q, Ma Q, Wei Y, Wang Y. Efficacy and safety of tenofovir disoproxil fumarate and tenofovir alafenamide fumarate in preventing HBV vertical transmission of high maternal viral load. Hepatol Int 2021; 15:1103-1108. [PMID: 34312798 DOI: 10.1007/s12072-021-10235-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 07/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a significant global health problem and > 42-52% of patients are infected during perinatal period. Tenofovir alafenamide fumarate (TAF) and tenofovir disoproxil fumarate (TDF) have been widely recognized as the main compounds used for antiviral treatment of hepatitis B. The present study evaluated the efficacy and safety of TAF in reducing HBV vertical transmission. METHODS A total of 72 pregnant women, who met the inclusion criteria, were randomly divided into the TDF (300 mg/day, n = 36) and TAF (25 mg/day, n = 36) groups. Clinical and laboratory data were analyzed and compared between the two groups. RESULTS No significant differences in alanine aminotransferase, total bilirubin, blood creatinine and blood urea nitrogen levels were noted between the two groups after treatment. The serum HBV DNA viral load and hepatitis B e antigen (HBeAg) levels of the two groups were significantly decreased following treatment, whereas the difference between the two groups was not statistically significant. The levels of urine retinol-binding protein and β2-microglobulin had no significant change after TAF treatment (p > 0.05), but increased significantly after TDF treatment (p < 0.05). All drug concentrations were undetectable in umbilical cord blood (UCB) and breast milk samples of the TAF group, while the drug concentration of UCB and breast milk samples in the TDF group was 2.98 ± 1.44 and 19.16 ± 15.26 ng/ml, respectively. All infants were tested negative for serum hepatitis B surface antigen, HBV DNA, and HBeAg. CONCLUSIONS Both TAF and TDF effectively block the mother-to-child transmission of hepatitis B. TAF was superior to TDF with regard to renal safety and breastfeeding.
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Affiliation(s)
- Baijun Li
- Cadre's Ward, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Zhaozhe Liu
- Oncology Department, General Hospital of Northern Theater Command, Shenyang, 110016, Liaoning, People's Republic of China
| | - Xing Liu
- Science and Education Department, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Dongchun Liu
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, People's Republic of China
| | - Mingyu Duan
- Clinical Chemistry Laboratory, Shenyang Beichuang Laboratory Co. Ltd, Shenyang, 110117, Liaoning, People's Republic of China
| | - Ye Gu
- Gastroenterology Departmentepartment, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Qiong Liu
- Cadre's Ward, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Qiang Ma
- Cadre's Ward, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China
| | - Yushi Wei
- Liaoning University of Traditional Chinese Medicine, Shenyang, 110034, Liaoning, People's Republic of China
| | - Yan Wang
- Science and Education Department, The Sixth People's Hospital of Shenyang, Shenyang, 110006, Liaoning, People's Republic of China.
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Ma X, Liu S, Wang M, Wang Y, Du S, Xin Y, Xuan S. Tenofovir Alafenamide Fumarate, Tenofovir Disoproxil Fumarate and Entecavir: Which is the Most Effective Drug for Chronic Hepatitis B? A Systematic Review and Meta-analysis. J Clin Transl Hepatol 2021; 9:335-344. [PMID: 34221919 PMCID: PMC8237148 DOI: 10.14218/jcth.2020.00164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/23/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS The therapeutic effect of tenofovir alafenamide fumarate (TAF), tenofovir disoproxil fumarate (TDF) and entecavir (ETV) on chronic hepatitis B (CHB) patients remains inconsistent. The aim of this study was to explore the differences in virological responses to TAF, TDF and ETV in patients with CHB. METHODS Literature searches were conducted of the PubMed, EMBASE, and the Cochrane Library databases to identify randomized controlled trials and observational studies published up to July 21, 2020. Statistical comparisons of virological response between TDF, ETV, and TAF were carried out with pooled odds ratio (OR) values. RESULTS The virological response in TDF-treated CHB patients was notably superior to that of the ETV-treated CHB patients after 12-weeks [OR=1.12, 95% confidence interval (CI): 0.89-1.41], 24-weeks (OR=1.33, 95% CI: 1.11-1.61), 48-weeks (OR=1.62, 95% CI: 1.16-2.25), 72-weeks (OR=1.43, 95% CI: 0.78-2.62), and 96-weeks (OR=1.56, 95% CI: 0.87-2.81) treatment. No significant difference was observed for the virological responses in CHB patients after 48-weeks treatment with TAF or TDF. The virological response in TDF+ETV-treated CHB patients was superior to that of TDF-treated CHB patients after 24-weeks, 48-weeks (OR=1.54, 95% CI: 1.17-2.02), 96-weeks, and 144-weeks. CONCLUSIONS The virological response in TDF-treated CHB patients was superior to that in ETV-treated CHB patients, but there was no significant difference between TAF and TDF. In addition, the therapeutic effect of TDF+ETV was superior to TDF alone.
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Affiliation(s)
- Xuefeng Ma
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
| | - Shousheng Liu
- Clinical Research Center, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
- Digestive Disease Key Laboratory of Qingdao, Qingdao, Shandong, China
| | - Mengke Wang
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
| | - Yifen Wang
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
| | - Shuixian Du
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
| | - Yongning Xin
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
- Digestive Disease Key Laboratory of Qingdao, Qingdao, Shandong, China
- Correspondence to: Yongning Xin, Department of Infectious Disease, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, Shandong 266011, China. ORCID: https://orcid.org/0000-0002-3692-7655. Tel: +86-532-8278-9463, Fax: +86-532-8596-8434, E-mail: ; Shiying Xuan, Department of Infectious Disease, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, Shandong 266011, China. ORCID: https://orcid.org/0000-0002-9849-1877. Tel: +86-532-8890-5508, Fax: +86-532-8890-5293, E-mail:
| | - Shiying Xuan
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
- Digestive Disease Key Laboratory of Qingdao, Qingdao, Shandong, China
- Correspondence to: Yongning Xin, Department of Infectious Disease, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, Shandong 266011, China. ORCID: https://orcid.org/0000-0002-3692-7655. Tel: +86-532-8278-9463, Fax: +86-532-8596-8434, E-mail: ; Shiying Xuan, Department of Infectious Disease, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, Shandong 266011, China. ORCID: https://orcid.org/0000-0002-9849-1877. Tel: +86-532-8890-5508, Fax: +86-532-8890-5293, E-mail:
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Wang T, Smith DA, Campbell C, Mokaya J, Freeman O, Salih H, McNaughton AL, Cripps S, Várnai KA, Noble T, Woods K, Collier J, Jeffery K, Davies J, Barnes E, Matthews PC. Hepatitis B virus (HBV) viral load, liver and renal function in adults treated with tenofovir disoproxil fumarate (TDF) vs. untreated: a retrospective longitudinal UK cohort study. BMC Infect Dis 2021; 21:610. [PMID: 34174833 PMCID: PMC8235844 DOI: 10.1186/s12879-021-06226-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/18/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Current clinical guidelines recommend treating chronic hepatitis B virus (HBV) infection in a minority of cases, but there are relatively scarce data on evolution or progression of liver inflammation and fibrosis in cases of chronic HBV (CHB) that do not meet treatment criteria. We aimed to assess the impact of TDF on liver disease, and the risk of renal impairment in treated CHB patients in comparison to untreated patients. METHODS We studied a longitudinal ethnically diverse CHB cohort in the UK attending out-patient clinics between 2005 and 2018. We examined TDF treatment (vs. untreated) as the main exposure, with HBV DNA viral load (VL), ALT, elastography scores and eGFR as the main outcomes, using paired tests and mixed effects model for longitudinal measurements. Additionally, decline of eGFR during follow-up was quantified within individuals by thresholds based on clinical guidelines. Baseline was defined as treatment initiation for TDF group and the beginning of clinical follow-up for untreated group respectively. RESULTS We included 206 adults (60 on TDF, 146 untreated), with a median ± IQR follow-up duration of 3.3 ± 2.8 years. The TDF group was significantly older (median age 39 vs. 35 years, p = 0.004) and more likely to be male (63% vs. 47%, p = 0.04) compared to the untreated group. Baseline difference between TDF and untreated groups reflected treatment eligibility criteria. As expected, VL and ALT declined significantly over time in TDF-treated patients. Elastography scores normalised during treatment in the TDF group reflecting regression of inflammation and/or fibrosis. However, 6/81 (7.4%) of untreated patients had a progression of fibrosis stage from F0-F1 to F2 or F3. There was no evidence of difference in rates or incidence of renal impairment during follow-up in the TDF vs. untreated group. CONCLUSIONS Risk of liver inflammation and fibrosis may be raised in untreated patients compared to those receiving TDF, and TDF may benefit a larger percentage of the CHB population.
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Affiliation(s)
- Tingyan Wang
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.,National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK
| | - David A Smith
- National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.,NIHR Health Informatics Collaborative, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Cori Campbell
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.,National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK
| | - Jolynne Mokaya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Oliver Freeman
- National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.,Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Hizni Salih
- National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.,Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Sarah Cripps
- Pharmacy Department, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kinga A Várnai
- National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.,NIHR Health Informatics Collaborative, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Theresa Noble
- National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.,NIHR Health Informatics Collaborative, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kerrie Woods
- National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.,NIHR Health Informatics Collaborative, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jane Collier
- Department of Hepatology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Katie Jeffery
- Department of Infectious Diseases and Microbiology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jim Davies
- National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, UK.,Department of Computer Science, University of Oxford, Oxford, UK
| | - Eleanor Barnes
- Nuffield Department of Medicine, University of Oxford, Oxford, UK. .,NIHR Health Informatics Collaborative, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - Philippa C Matthews
- Nuffield Department of Medicine, University of Oxford, Oxford, UK. .,NIHR Health Informatics Collaborative, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. .,Department of Infectious Diseases and Microbiology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
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11
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Fu Y, Duan F, Du Z. Visible Light Driven Oxidative Coupling of Amines and P(O)−H/P−OR Compounds under Photocatalyst‐Free Conditions. ASIAN J ORG CHEM 2021. [DOI: 10.1002/ajoc.202100052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Ying Fu
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education College of Chemistry and Chemical Engineering Northwest Normal University Lanzhou 730070 P. R. China
| | - Fei Duan
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education College of Chemistry and Chemical Engineering Northwest Normal University Lanzhou 730070 P. R. China
| | - Zhengyin Du
- Key Laboratory of Eco-functional Polymer Materials of the Ministry of Education College of Chemistry and Chemical Engineering Northwest Normal University Lanzhou 730070 P. R. China
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12
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Kumada T, Toyoda H, Tada T, Yasuda S, Miyake N, Tanaka J. Comparison of the impact of tenofovir alafenamide and entecavir on declines of hepatitis B surface antigen levels. Eur J Gastroenterol Hepatol 2021; 32:255-260. [PMID: 32282538 DOI: 10.1097/meg.0000000000001733] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Tenofovir alafenamide is a new prodrug of tenofovir that allows for the treatment of patients with hepatitis B virus (HBV) at a lower dose than with tenofovir disoproxil fumarate, due to the more efficient delivery of tenofovir to hepatocytes. In this study, we compared entecavir and tenofovir alafenamide in terms of their ability to reduce hepatitis B surface antigen (HBsAg) in the same group of patients with HBV infection. METHODS During March and June 2018, 129 patients who received entecavir were switched to tenofovir alafenamide. Every 3- 6 months for 1 year before and after switching to tenofovir alafenamide, all patients underwent measurements of HBsAg, hepatitis core-related antigen (HBcrAg), calcium (Ca), inorganic phosphorus, and estimated glomerular filtration rate (eGFR). RESULTS The percent decline rate during the entecavir and tenofovir alafenamide phases at 6 months were 2.38% (-3.57 to 0.00) and -3.57% (-7.14 to 0.00), respectively, and those at 12 months were 3.03% (-6.57 to 0.00) and -5.56% (-7.41 to -2.50), respectively. HBsAg levels were reduced significantly more during the tenofovir alafenamide phase than during the entecavir phase (P < 0.0001). There were no significant differences in the percent declines of HBcrAg, Ca, inorganic phosphorus, or eGFR during the entecavir and tenofovir alafenamide phases after 1 year. CONCLUSION tenofovir alafenamide significantly decreased HBsAg levels compared to entecavir.
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Affiliation(s)
- Takashi Kumada
- Department of Nursing, Faculty of Nursing, Gifu Kyoritsu University
| | - Hidenori Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu
| | - Toshifumi Tada
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu
| | - Satoshi Yasuda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu
| | - Nozomi Miyake
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Hiroshima, Japan
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13
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Chen X, Luo W, Wang Y, Li Z, Ma X, Peng AY. Efficient Synthesis of Phosphonamidates through One-Pot Sequential Reactions of Phosphonites with Iodine and Amines. Chemistry 2020; 26:14474-14480. [PMID: 32776399 DOI: 10.1002/chem.202002934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Indexed: 11/10/2022]
Abstract
A one-pot sequential strategy to construct phosphonamidates has been developed by generating phosphonites in situ from arylmagnesium bromides and triethyl phosphite followed by treatment with iodine and amines. A variety of phosphonamidates were obtained with good to excellent yields at room temperature from easily available materials.
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Affiliation(s)
- Xunwei Chen
- School of Chemistry, Sun Yat-sen University, 135 Xingangxi Lu, Guangzhou, China
| | - Wenjun Luo
- School of Chemistry, Sun Yat-sen University, 135 Xingangxi Lu, Guangzhou, China
| | - Yanlin Wang
- School of Chemistry, Sun Yat-sen University, 135 Xingangxi Lu, Guangzhou, China
| | - Zikang Li
- School of Chemistry, Sun Yat-sen University, 135 Xingangxi Lu, Guangzhou, China
| | - Xiaorui Ma
- School of Chemistry, Sun Yat-sen University, 135 Xingangxi Lu, Guangzhou, China
| | - Ai-Yun Peng
- School of Chemistry, Sun Yat-sen University, 135 Xingangxi Lu, Guangzhou, China
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14
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Cavalera S, Agulló C, Mercader JV, Di Nardo F, Chiarello M, Anfossi L, Baggiani C, D'Avolio A, Abad-Somovilla A, Abad-Fuentes A. Monoclonal antibodies with subnanomolar affinity to tenofovir for monitoring adherence to antiretroviral therapies: from hapten synthesis to prototype development. J Mater Chem B 2020; 8:10439-10449. [PMID: 33124633 DOI: 10.1039/d0tb01791d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Approximately 32 million people have died of HIV infection since the beginning of the outbreak, and 38 million are currently infected. Among strategies adopted by the Joint United Nations Programme on HIV/AIDS to end the AIDS global epidemic, the treatment, diagnosis, and viral suppression of the infected subjects are considered crucial for HIV prevention and transmission. Although several antiretroviral (ARV) drugs are successfully used to manage HIV infection, their efficacy strictly relies on perfect adherence to the therapy, which is seldom achieved. Patient supervision, especially in HIV-endemic, low-resource settings, requires rapid, easy-to-use, and affordable analytical tools, such as the enzyme-linked immunosorbent assay (ELISA) and especially the lateral flow immunoassay (LFIA). In this work, high-affinity monoclonal antibodies were generated to develop ELISA and LFIA prototypes for monitoring tenofovir (TFV), an ARV drug present in several HIV treatments. TFV was functionalized by inserting a carboxylated C5-linker at the phosphonic group of the molecule, and the synthetic derivative was conjugated to proteins for mice immunization. Through a rigorous screening strategy of hybridoma supernatants, a panel of monoclonal antibodies strongly binding to TFV was obtained. Following antibody characterization for affinity and selectivity by competitive ELISA, a LFIA prototype was developed and tentatively applied to determine TFV in simulated urine. The point-of-care test showed ultra-high detectability (the visual limit of detection was 2.5 nM, 1.4 ng mL-1), excellent selectivity, and limited proneness to matrix interference, thus potentially making this rapid method a valuable tool for the on-site assessment of patient adherence to ARV therapy.
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Affiliation(s)
- Simone Cavalera
- Department of Chemistry, University of Turin, Turin, TO, Italy.
| | - Consuelo Agulló
- Departamento de Química Orgánica, Universitat de València, Burjassot, Valencia, Spain
| | - Josep V Mercader
- Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC), Paterna, Valencia, Spain.
| | - Fabio Di Nardo
- Department of Chemistry, University of Turin, Turin, TO, Italy.
| | | | - Laura Anfossi
- Department of Chemistry, University of Turin, Turin, TO, Italy.
| | | | - Antonio D'Avolio
- Department of Medical Sciences, Unit of Infectious Diseases, University of Torino, Torino, Italy
| | | | - Antonio Abad-Fuentes
- Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC), Paterna, Valencia, Spain.
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15
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Alghamdi AS, Alothmani HS, Mogharbel M, Albiladi H, Babatin M. Clinical Characteristics of Hepatitis B Virus Patients After Switching to Tenofovir Alafenamide Fumarate: A Retrospective Observational Study. Cureus 2020; 12:e10380. [PMID: 33062501 PMCID: PMC7550005 DOI: 10.7759/cureus.10380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Hepatitis B Virus (HBV) continues to be a significant global health problem despite vaccination programs and effective antiviral drugs. Aim Assess tenofovir alafenamide fumarate (TAF) as a new treatment modality in light of the clinical characteristics of HBV patients. Settings and design A real-world observational study Methods and material We collected data of 71 HBV patients and recorded the hepatitis B virus deoxyribonucleic acid (HBV-DNA) plasma levels and biochemistry test results for the alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum creatinine levels at three time points, including baseline, time of switching to TAF, and six months after switching. Results From the time of switching to TAF till six months later, HBV-DNA plasma levels significantly decreased from 838.61 IU/mL to 16.7 IU/mL (p-value of <0.05). ALT and AST levels dropped from 29.05 U/L to 27 U/L and from 21.34 U/L to 20.7 U/L (p-values 0.328 and 0.410, respectively). Although TAF did not show a statistically significant reduction in the serum levels of AST, ALT, and creatinine, it showed a detectable maintenance level. Conclusions In the evaluated cohort, all clinical characteristics of HBV were maintained six months after switching patients to TAF.
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16
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Pierra Rouviere C, Dousson CB, Tavis JE. HBV replication inhibitors. Antiviral Res 2020; 179:104815. [PMID: 32380149 PMCID: PMC7293572 DOI: 10.1016/j.antiviral.2020.104815] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/22/2020] [Accepted: 04/28/2020] [Indexed: 12/21/2022]
Abstract
Chronic Hepatitis B Virus infections afflict >250 million people and kill nearly 1 million annually. Current non-curative therapies are dominated by nucleos(t)ide analogs (NAs) that profoundly but incompletely suppress DNA synthesis by the viral reverse transcriptase. Residual HBV replication during NA therapy contributes to maintenance of the critical nuclear reservoir of the HBV genome, the covalently-closed circular DNA, and to ongoing infection of naive cells. Identification of next-generation NAs with improved efficacy and safety profiles, often through novel prodrug approaches, is the primary thrust of ongoing efforts to improve HBV replication inhibitors. Inhibitors of the HBV ribonuclease H, the other viral enzymatic activity essential for viral genomic replication, are in preclinical development. The complexity of HBV's reverse transcription pathway offers many other potential targets. HBV's protein-priming of reverse transcription has been briefly explored as a potential target, as have the host chaperones necessary for function of the HBV reverse transcriptase. Improved inhibitors of HBV reverse transcription would reduce HBV's replication-dependent persistence mechanisms and are therefore expected to become a backbone of future curative combination anti-HBV therapies.
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Affiliation(s)
| | - Cyril B Dousson
- Ai-biopharma, Medicinal Chemistry Department, Montpellier, France.
| | - John E Tavis
- Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA.
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17
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Charlton MR, Alam A, Shukla A, Dashtseren B, Lesmana CRA, Duger D, Payawal DA, Duy Cuong D, Jargalsaikhan G, Cua IHY, Sollano JD, Singh KR, Madan K, Win KM, Kyi KP, Tun KS, Salih M, Rastogi M, Saraf N, Thuy PTT, Hien PTD, Gani RA, Mohamed R, Tanwandee T, Piratvisuth T, Sukeepaisarnjaroen W, Naing W, Hashmi ZY. An expert review on the use of tenofovir alafenamide for the treatment of chronic hepatitis B virus infection in Asia. J Gastroenterol 2020; 55:811-823. [PMID: 32666200 PMCID: PMC7452871 DOI: 10.1007/s00535-020-01698-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/25/2020] [Indexed: 02/06/2023]
Abstract
Asia has intermediate-to-high prevalence and high morbidity of hepatitis B virus (HBV) infection. The use of guideline-recommended nucleos(t)ide analogs with high barrier to resistance, such as entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF), is one of the key interventions for curbing HBV infection and associated morbidity in Asia. However, there are some challenges to the use of ETV and TDF; while ETV is associated with high resistance in lamivudine (LAM)-exposed (especially LAM-refractory) patients; bone and renal safety issues are a major concern with TDF. Hence, a panel of twenty-eight expert hepatologists from Asia convened, reviewed the literature, and developed the current expert opinion-based review article for the use of TAF in the resource-constrained settings in Asia. This article provides a comprehensive review of two large, phase 3, double-blind, randomized controlled trials of TAF versus TDF in HBeAg-negative (study 0108) and HBeAg-positive (study 0110) chronic HBV patients (> 70% Asians). These studies revealed as follows: (1) non-inferiority for the proportion of patients who had HBV DNA < 29 IU/mL; (2) significantly high rate of normalization of alanine aminotransferase levels; (3) no incidence of resistance; and (4) significantly better bone and renal safety, with TAF vs. TDF up to 144 weeks. Considering the benefits of TAF, the expert panel proposed recommendations for optimizing the use of TAF in Asia, along with guidance on specific patient groups at risk of renal or bone disease suitable for TAF therapy. The guidance provided in this article may help clinicians optimize the use of TAF in Asia.
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Affiliation(s)
- Michael R. Charlton
- Transplant Institute, Center for Liver Diseases, University of Chicago Biological Sciences, 5841 South Maryland Avenue, Chicago, Illinois USA
| | | | - Akash Shukla
- Department of Gastroenterology, LTM Medical College and Sion Hospital, Maharashtra Mumbai, India
| | | | - Cosmas Rinaldi Adithya Lesmana
- Department of Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Davadoorj Duger
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Diana Alcantara Payawal
- Department of Medicine, Cardinal Santos Medical Center, Mandaluyong, Metro, Manila, Philippines
| | - Do Duy Cuong
- Department of Infectious Diseases and HIV Outpatient Clinic, Bach Mai Hospital, Hanoi, Vietnam
| | - Ganbolor Jargalsaikhan
- Department Liver Center, Ulaanbaatar, Mongolia ,Department International Graduate Program in Medicine (IGPM) Institution, Ulaanbaatar, Mongolia ,College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ian Homer Yee Cua
- Research Committee and Social Committee, Institute of Digestive and Liver Diseases, St. Luke’s Medical Center, Taguig, Philippines
| | - Jose Decena Sollano
- Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines
| | | | - Kaushal Madan
- Gastroenterology & Hepatology, Max Smart Super Speciality Hospital, Saket, New Delhi, India
| | | | - Khin Pyone Kyi
- Myanmar Liver Foundation, Liver Foundation, Yangon, Myanmar
| | | | - Mohd. Salih
- Department of Hepatology, Quaid e Azam International Hospital, Islamabad, Pakistan
| | - Mukul Rastogi
- Department of Hepatology and Gastroenterology, Fortis Hospital, Noida, India ,Department of Transplant Hepatology, Fortis Hospital, Noida, India
| | - Neeraj Saraf
- Clinical/Transplant Hepatology Institute of Digestive and Hepatobiliary Sciences Medanta, The Medicity, Gurgaon, New Delhi India
| | | | - Pham Tran Dieu Hien
- Department of Infectious Disease, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | - Rino Alvani Gani
- Liver Transplantation team, Ciptomangunkusumo Hospital, Jakarta, Indonesia
| | - Rosmawati Mohamed
- Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Tawesak Tanwandee
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Teerha Piratvisuth
- Department of Medicine, NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Prince of Songkla University, Hat Yai, Thailand
| | - Wattana Sukeepaisarnjaroen
- Gastroenterology Unit, Department of Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Win Naing
- Department of Hepatology, Yangon General Hospital, University of Medicine (1), Yangon, Myanmar
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