ABSTRACT Objective:To study the clinical efficacy of long term tenofovir disoproxil fumarate (TDF) based rescue therapy in patients with chronic hepatitis B who were resistant to nucleoside/nucleotide analogs. Methods:The objects of this retrospective study were 40 patients with chronic hepatitis B who were resistant to nucleoside/nucleotide analogs. After receiving the TDF based rescue therapy and during a median of 45 months’ follow up, the analysis was performed for these 40 patients (range 14 99 months) . Viral response, changes in hepatitis B surface antigen levels from the baseline, and viral breakthrough during therapy were analyzed. Results:The proportion of patients with undetectable serum hepatitis B virus (HBV) DNA levels during TDF based rescue therapy were 68%, 78%, 85%, 88%, 83%, 81%, 88% and 100% respectively during 0.5 4 years. There were no differences in the viral response rate between the TDF plus LAM group and the TDF plus ETV group. The mean reduction from the baseline in hepatitis B surface antigen levels in patients with LAM resistant HBV was greater than the reductions in patients with adefovir dipivoxil (ADV) resistant or ETV resistant HBV at 2 and 3 years (P<0.05). However, two patients with ADV or ETV resistant HBV at the baseline developed viral breakthrough during TDF based rescue therapy. Conclusion:Long term therapy with a TDF based rescue regimen demonstrated high viral suppression in patients received LAM plus ADV combination therapy, ETV plus ADV combination therapy, or ETV monotherapy had failed. |