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Tenofovir Leads to Regression of Fibrosis and Cirrhosis
http://www.natap.org/2013/HBV/TDFandregressionoffibrosisLancet.pdf


Long-term HBV Suppression With Tenofovir Leads to Regression of Fibrosis and Cirrhosis
Date posted: 6/20/2013
Long-term open-label follow-up study[1]
Summary of Key Conclusions
In patients with HBeAg-negative or HBeAg-positive chronic hepatitis B, treatment with tenofovir for up to 5 years yielded documented histologic improvement in 87% and fibrosis regression in 51%
74% of patients with cirrhosis at baseline no longer had cirrhosis at Year 5, whereas only 1% of patients without baseline cirrhosis progressed to cirrhosis at Year 5 (P < .0001)
Lower body mass index (BMI) independently associated with cirrhosis reversal
Virologic suppression maintained in vast majority of patients in on-treatment analysis
Tenofovir well tolerated long term, with no treatment-limiting toxicity
No emergence of tenofovir resistance associated mutations in the few patients with virologic breakthrough
Study authors conclude that results are broadly applicable given range of patients included in study
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Avatar_universal
Can anybody explain how that virologic breakthrough works ? I mean since there is no resistance how does the virus breakthrough ?
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i think there are two types when not resistance:

patients forgetting to take the pills

immune response, maybe intf gamma purging virions hidden inside infected cells.i myself had this in october 2012 when my hbvdna becomes 31iu/ml while on entecavir plus tenofovir, at the same time hbsag went from about 4300iu/ml to 3600iu/ml immediately exactly the same days.

this happened exactly when i tried daily imiquimod suppository, this probably increased immeun response of interferons and cytokines and this was the result....at the same time i also had creatinine increase to 1.2, vision decline and all the symtoms of interferon/cytokines inflammation, do daily imiquimod is borderline with sides effects
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it would be useful if they study these breakthru but as shown on studies they look not interested in this, a simple check of hbsag quant and cytokines during breakthrough could tell if this is immune response, resistance or missing pills

as for resistance a study with ultradeep sequence is also needed to know the minor viral populations
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Steff, what do you connect vision decline with?
I have also vision decline since the last year, I wonder if it is connected to hbv anyhow?
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sorry used wrong words in english, blurred vision...it is a side effect of intf too and with imiquimod it lasts about 1 day, it is not so heavy you can see normally but not so clear
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I see, probably I just getting older...
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That is all BS what they write. These drugs only stop viral assembly in blood. Inside the  liver the damage process goes on.

And the rest of the body damage do to toxicity of these drugs why they dont report it?

High blood pressure
Kidney damage
Thyroid work impairment
Hair growth stop
Lympodystrophy and muscle loss
Lactic acid build up
Macrophage toxicity
possilble dna damage
fatty liver build up

These people have access to better  drugs but dont use them. Instead it is tdf or etv. Dont people get it that these drugs kill at about the same rate as hbv does?

It is enough talk about these nucs. Demand better drugs people.
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Tenofovir Leads to Regression of Fibrosis and Cirrhosis
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