General Information:

• Hepatitis B virus (HBV) is a common cause of cirrhosis, end-stage liver disease, and hepatocellular carcinoma, particularly in areas of the world where infection rates are high.
• More than 240 million people have chronic HBV infections and about 600,000 people die every year due to the acute or chronic consequences.
• The antiviral tenofovir (used in HIV treatment) has shown recent promise in not only prolonging progression to cirrhosis but actually reversing cirrhosis.
• Phase III trial results of 5 years of tenofovir treatment showed an 87% improvement in histology. Notably, of the 96 patients with cirrhosis prior to treatment, 74% were no longer cirrhotic at year 5 of therapy and only 2 went on to decompensated liver disease.

Bottom Line:

Tenofovir has already become standard therapy for HIV (contained in Truvada and Atripla). This HBV study shows promise that this drug can not only decrease progression of disease but also reverse the cirrhosis associated with long-term infection. Given the prevalence of chronic HBV, larger scale role-out of this drug could markedly change the epidemiologic landscape of morbidity and mortality due to hepatitis B.

 

University of Maryland Section of Global Emergency Health

Author: Emilie J.B. Calvello

References

References: Marcellin P et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: A 5-year open-label follow-up study. Lancet 2012 Dec 10.