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Tenofovir 300 mg daily is effective in patients with chronic HBV who fail lamivudine.

Bennet Cecil, MD

Background & Aims: Lamivudine is a FDA approved treatment for patients with chronic HBV, but loss of response is common, and some patients have a poor initial response. Tenofovir is FDA approved for the treatment of HIV, and can be used off label for patients with lamivudine resistant HBV.

Methods: Five patients, three with cirrhosis, with a poor response to lamivudine 100-300 mg per day were offered tenofovir 300 mg daily. The log10 HBV-DNA concentration with lamivudine therapy and with tenofovir were compared using the paired t test.

Results: Tenofovir caused a mean 4.8 log10 fall in HBV-DNA, which was a significant fall by the paired student t test, t-value=7.142, P-value .0020. All three cirrhotic patients had clinical and biochemical improvement with tenofovir.

Conclusions:
Tenofovir 300 mg daily results in a significant fall in HBV-DNA in patients who fail lamivudine, resulting in clinical and biochemical improvement in cirrhotic patients. It can be used off label until adefovir is FDA approved.