Tenofovir Disoproxil Fumarate Rescue Therapy For Multi-drug Resistance Chronic Hepatitis B

Objective: To investigate the efficacy and safety of Tenofovir Disoproxil fumarate-based rescue therapy for Multi-drug Resistance(MDR)Chronic Hepatitis B(CHB).Methods: Twenty-four Chronic Hepatitis B patients who had poor efficacy in the course of antiviral therapy and diagnosed with multi-drug resistance(MRD)by PCR direct sequencing in Department of Infectious Diseases of First Affiliated Hospital of Soochow University were enrolled in the study.These patients were divided into two groups:thirteen patients accepted Tenofovir disoproxil fumarate(TDF)300 mg/d alone,the other patients acceped TDF 300mg/d plus Entecavir(ETV)0.5 mg/d.The HBV DNA,hepatitis B two and a half markers,the serum markers of liver and kidney function were compared between before and after saving treatment.After the follow-up of 12 months,the Kaplan-Meier survival analysis was used to assess the cumulative complete virologic response(CVR)rate and cumulative nomalized ALT rates in all patients.Meanwhile,it was also used to compare the cumulative CVR rates between patients undergone TDF and TDF plus ETV.Results: The cumulative CVR rates at 1,3,6,9 and 12 month were 8.3%,25.0%,45.8%,62.5% and 95.8% respectively after TDF-based rescue therapy.The cumulative normalized ALT rates at 1,3,6,9 and 12 month were 33.3%,66.7%,87.5%,91.7% and 100%.There was no difference in the cumulative CVR rates beteween the TDF monotherepy and TDF plus ETV(Log-rank,P=0.483).No significant difference was found in serological response rates between two groups.There were no renal dysfunction or other adverse events observed during treatment.Conclusion: 1)TDF based rescue therapy is effective and safe in Multi-drug Chronic Hepatitis B.2)There is no difference in virological response between TDF monotherapy and TDF plus ETV.