P1064 Randomized Trial of Tenofovir Monotherapy Versus Tenofovir Plus Entecavir Combination Therapy in Chronic Hepatitis B Patients With Genotypic Resistance Mutations to Adefovir

Is tenofovir disoproxil fumarate an all-powerful weapon in the treatment of chronic hepatitis B?

“…The results of Kim et al [ 5 ] provide further support for the findings of those randomized controlled studies [ 11 , 12 , 13 ] suggesting a similar antiviral efficacy of TDF monotherapy and TDF plus nucleoside analogue combination therapy for CHB patients with one or more resistance mutations. However, there are also several reports showing that the antiviral effect of TDF monotherapy is limited in patients with ADV mutations, especially ADV double mutations [ 10 , 12 ]. Furthermore, considering the frustrating and disappointing experience in the previous era of antivirals with a low genetic barrier, the potential development of TDF resistance after several years of treatment in patients with persistent viremia in spite of TDF monotherapy or combination therapy cannot be ruled out.…”

“…Recently, several well-controlled randomized studies of TDF-based regimens have been reported [ 11 , 12 , 13 ]. Their aim was to determine the optimal therapeutic strategy for CHB patients with confirmed antiviral resistance mutations.…”

“…A randomized controlled study involving five Korean medical centers was carried out in patients with ADV resistance receiving TDF-based therapy [ 12 ]. Patients with documented ADV resistance mutations and serum HBV DNA > 60 IU/mL were randomized to receive TDF monotherapy (n = 50) or a combination of TDF + ETV (n = 52) for 48 weeks.…”