Kinetik von HBs-Antigen-Spiegeln bei Patienten mit chronischer Hepatitis B während 4 Jahren Therapie mit Tenofovir oder Adefovir

Aims: The ultimate endpoint in antiviral treatment of chronic HBV infections is the clearance of HBsAg. As recently shown, during 2 years of treatment with the nucleotide analogue tenofovir (TDF) the loss of HBsAg can be predicted by baseline and on- treatment parameters. We investigated serum HBsAg levels in patients treated with either TDF or adefovir (ADV) up to 4 years. Methods: 116 patients (77 male, 81 HBeAg positive, mean HBV DNA 7.1±2 [range, 4–9.1] copies/mL, HBV genotypes A, B, C, D, E in 41, 5, 11, 55, 2 patients) with chronic HBV infection and treatment with either ADV 10mg (n=61) or TDF 300mg/day (n=55) (mean±SD duration of 21±11 [6–43] and 32±12 [9–52] months) were retrospectively analyzed. Serum HBsAg levels were quantified from frozen serum samples from baseline, months 6, 12, 24, 36 and 48 (Abbott Architect HBsAg assay). Results: Antiviral treatment significantly reduced HBsAg levels from baseline (mean 4.0±0.8 [1.5–5.4] log10 IU/mL) to month 6 (3.7±0.8[0–5.1] log10 IU/mL;p=0.01), month 12 (3.6±5.1 [0–5.1] log10 IU/mL; p=0.003), month 24 (3.5±0.9[0.9–4.7] log10 IU/mL;p=0.006), month 36 (3.4±0.9 [1.2–4.7] log10 IU/mL; p=0.002) and month 48 (3.3±0.5[0–4] log10 IU/mL; p=0.002). After a mean duration of 23±12 [9–42] months, 7 patients lost HBsAg (all genotype A). Compared to patients without HBsAg loss, these patients had a stronger decrease of HBsAg levels at month 6 (mean levels 3.8±0.7 [1–5.1] vs. 2.8±1.7[0–4.2] log10 IU/mL; p=0.012) and month 12 of treatment (mean 3.8±0.7 [1.6–5.1] vs. 0.9±1.9 [0–3.7] log10 IU/mL; p<0.000), however HBsAg levels were similar at baseline.

HBsAg - Hepatitis B - Tenofovir