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
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
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
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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