Is tenofovir effective as the first-line therapy for hepatitis B (HBV) (Hep B)?

Updated: Jun 08, 2021
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Marcellin et al reported that patients who received tenofovir continuously for 240 weeks had sustained suppression of HBV DNA levels below 400 copies/mL (HBeAg-negative patients: 83%; HBeAg-positive patients: 65%). [60] Patients who were randomized to adefovir and then, at week 48, rolled over to tenofovir for the subsequent 192 weeks also maintained viral suppression (HBeAg-negative patients: 84%; HBeAg-positive patients: 66%).

Of the HBeAg-positive patients who received tenofovir through 240 weeks, 9% experienced s-antigen loss, and 7% seroconverted. The HBeAg loss rate was 46%, and the HBeAg seroconversion rate was 40%. No evidence of resistance to tenofovir emerged over the treatment period. [60]

In addition, 87% of the 348 patients who had paired biopsies at baseline and week 240 experienced an improvement in the overall liver histology, as measured by an improvement of a minimum of 2 points in the Knodell necroinflammatory score without worsening in the Knodell fibrosis score. Of the 96 patients who had cirrhosis (Ishak fibrosis score ≥5) at the start of therapy, 74% experienced regression of cirrhosis. [60]

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