Treatment of Chronic Hepatitis B with Tenofovir

Tenofovir is among the first-line treatments for chronic hepatitis B (CHB) virus infection. We evaluated the efficacy of Tenofovir in the treatment of Iranian adult patients with CHB. In a retrospective study, we evaluated 154 HBsAg positive patients referred to Sadoughi hospital in Yazd-Iran for treatment during 2009-2014. Forty-five patients were naive and 109 patients were treated previously with lamivudine or interferon. HBs Ag, HBeAg, HBeAb and quantitative HBV- DNA PCR were measured. The patients with HBV DNA >10,000 copy per ml in precore mutant and HBV DNA>100,000 copy per ml in wild type and ALT >two times of normal value were included. Tenofovir disoproxil fumarate 300 mg was administered and continued for three years. Data were analyzed using SPSS19. We enrolled 154 (109 males 45 female) patients. Mean age of patients was 41± 8 years (18-58 year old). Forty-five of them were naive and the rest had previously experienced treatment. In this study, 113 of patients were of wild type and 41 patients were precore mutant variant. In wild type patients, 25 ones were naive and in precore mutant subtype, 20 patients were naive.
HBsAg disappeared in 5 patients (3.2 percent). Forty one of 45 patients in the naive group (91 percent) and 96 of 109 patients in the previously treated group (88 percent) were cured. AST and ALT levels decreased in over 80 percent of patients and means of AST and ALT levels showed more decrease in naive and precore mutant subgroups. Serum AST and ALT and HBV DNA were higher in the wild type group than in the precore mutant group. Seroconversion occurred in 69 out of 113 patients at the end of the study. Treatment response rate to Tenofovir in Iranian patients with CHB was high. Tenofovir could be recommended as the first-line therapy of chronic HBV infection in Iran.