An international study found the antiviral combination of tenofovir and emtricitabine (Truvada) was most effective in treating younger adult hepatitis B patients with high viral load and normal ALT levels.
Doctors historically have not treated this group because there appeared to be no sign of liver damage. However, doctors now know that high viral loads may increase patients’ risk of liver damage and cancer as they age, despite their normal ALT levels.
http://www.streetinsider.com/Corporate+News/ContraVir+Pharma+(CTRV)+Commences+Screening+for+CMX157+Phase+1+in+HBV/11435348.html
ContraVir Pharmaceuticals, Inc. (Nasdaq: CTRV) announced that it has commenced screening healthy volunteers for enrollment into the Phase 1 portion of the Company's Phase 1/2a multiple ascending dose clinical study of CMX157, ContraVir's novel, highly potent lipid conjugate of tenofovir for treating hepatitis B virus (HBV) infection.
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
This distinction may be important given the development of tenofovir alafenamide fumarate (TAF), a tenofovir prodrug with low concentrations of plasma tenofovir but high concentrations of intracellular tenofovir diphosphate (26).
For the first 39 months of use of entecavir/tenofovir there is not significant difference in HCC development for tenofovir vs entecavir for non-cirrhotic...as probably expected since pre-malignancy was probably already developed in those HCC cases. For Cirrhotic tenofovir maybe seems to be just slightly better option.
For non-cirrhotic usage of interferon in the past reduced chances of HCC by 29% in this study.
"A study showed that tenofovir is very effective in NA treatment-experienced populations, with 79% of patients achieving unquantifiable HBV DNA by the assay used (< 80 IU/mL) after a mean treatment period of 23 months."
What is NA ?
tenofovir, no resistance
entecavir, 1,5% resistance but cannot be used on those using lamivudine because in this case resistance can go higher than 50%
interferon
if i had a doctor prescribing me such rubbish useless toxic.....i d destroy his life....
There is also a study that involved stopping Tenofovir treatment after a prolonged period. A very small percentage of patients may clear HBsAg, most will have viralogical (hbvdna) and biological (ALT) rebounds. Among these, some will have a decrease in qHBsAg. This leads to speculation whether a sequence of start-stop-restart of NUC may be a way to reduce qHBsAg.
of course nobody must think to seroconvert under entecavir, percentages are so small but if italian you might consider this study when choosing entecavir or tenofovir and check hbsag baseline and 12 weeks if any hbsag decrease happens since if you fall in the small percentage seroconversion is very fast in the first 1-2 years
on tenofovir the percentage is an absolute 0% at 3 years on hbe negative, so absolutely no chances in this case.
The following is a paper from doctors in Francel. It said you can breastfeed whilst your are on Tenofovir because "Tenofovir is not absorbed in the breast milk". However, I have googled and cannot find any reference to this claim. All the best to you and your baby.
Clin Res Hepatol Gastroenterol.
2011 Jun 7. [Epub ahead of print]
Hepatitis B virus infection and pregnancy.
Pol S, Corouge M, Fontaine H.
A previous phase 2 study of tenofovir monotherapy PrEP for women in Africa saw no HBV flares after stopping the drug among participants who started with normal ALT and AST levels, the researchers noted as background. Other PrEP studies have excluded people with hepatitis B.
The iPrEx investigators performed hepatitis B serology tests at study entry and again at the time of Truvada discontinuation.
Tenofovir alafenamide (TAF), a new formulation that reaches higher levels in cells but allows for lower dosing, was as effective as the current tenofovir disoproxil fumarate (TDF) formulation but had less impact on markers of kidney function and bone turnover, researchers reported at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2013) this week in Denver.
You are correct that Truvada is a combination of tenofovir and emtricitabine, and is generally prescribed for patients with HIV. Being a HBV forum, most of us know very little about Truvada except that it is prescribed off-label for HBV by some doctors, and that it is recommended for HBV patients who develop resistance to Tenofovir.
That is actually not much better than tenofovir vs tenofovir disoproxil fumarate, the actual substance in Viread. It is 50 times more potent than tenofovir.
It is all this improper simplification of callling viread tenofovir.
Tenovovir, if it would be given orally, would have no effect on HBV.
TEnofovir if given intravenously or sc would still have almost no effect on HBV in the liver. the substance has a high negative charge and cannot easlily penetrate cell membranes.
i wouldn t worry about that but just concentrate on combos of everything working on hbsag and take it down especially when not too high
i would be wonderful to get data from india and china hospitals making the combos like reported from india, i am sure most get hbsag decrease on interferon+alinia+tenofovir continuous therapy
Participants in this open-label study were randomly assigned to either stop tenofovir or continue therapy for 144 weeks. Tenofovir could be restarted if clinically significant hepatitis B flares occurred.
The primary endpoint was HBsAg loss at week 144, considered the closest approximation to a cure. Berg presented interim 48-week findings; 21 participants in the stop-tenofovir group and 21 in the continuous-tenofovir group completed 48 weeks and were included in this analysis.
That said, my Hepatologist at California CMPC asked me to join a study to stop treatment recently. Which I was excited to try.
However, after doing another biopsy last month, my results are in and I'm at stage "2 to 2.5" so to speak Fibrosis. He said because of this, I am too "at risk" to stop medication. He's afraid that I might flare up quickly and potentially reach cirrhosis quickly. He asked that I switch to Tenofovir immediately to avoid mutation.
Treatment with PEG-IFN combined with adefovir has shown HBsAg loss in patients with CHB who were hepatitis B e antigen (HBeAg) negative and had low baseline serum HBsAg, and a study of PEG-IFN combined with tenofovir indicated high rates of HBsAg loss.
The primary aim of this prospective open-label trial was to determine the rate of HBsAg loss in patients with CHB with low viral load being treated with PEG-IFN plus adefovir or tenofovir.
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