Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Mar 18, 2021; 12(2): 32-39
Published online Mar 18, 2021. doi: 10.4292/wjgpt.v12.i2.32
Histopathological evaluation of long-term tenofovir disoproxil fumarate treatment in patients with hepatitis be antigen-negative chronic hepatitis B
Bahri Abayli, Cansu Abaylı, Genco Gencdal
Bahri Abayli, Cansu Abaylı, Seyhan Devlet Hastanesi, Adana 090, Turkey
Genco Gencdal, Department of Gastroenterology, Hepatology and Liver Transplantation, Koc University, School of Medicine, İstanbul 34300, Turkey
Author contributions: Abayli B and Abaylı C were responsible for the concept, clinical follow-up of patients, writing of article, supervision; Gencdal G was responsible for the concept, study design, organization and coordination of the trial, data analysis, writing of article, supervision; all members of the study team contributed to the management or administration of the trial.
Institutional review board statement: This retrospective study was organised in accordance with the Helsinki Declaration. Local ethics committee approval was obtained (No. 11.03.2020-52/756).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: For all of authors of this manuscript, there is no potential, personal, financial arrangement (e.g., employment, consultancies, honoraria, stock ownership or options, expert testimony, grants/patents received, and royalties) with a company whose product figures prominently in the submitted manuscript or with a company that makes a competing product.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Genco Gencdal, MD, Associate Professor, Department of Gastroenterology, Hepatology and Liver Transplantation, Koc University, School of Medicine, özel GOP hastanesi endoskopi birimi gop istanbul, İstanbul 34300, Turkey.gencogencdal@yahoo.co.uk
Received: December 18, 2020
Peer-review started: December 18, 2020
First decision: January 10, 2021
Revised: January 10, 2021
Accepted: March 10, 2021
Article in press: March 10, 2021
Published online: March 18, 2021
Processing time: 89 Days and 23.5 Hours
Abstract
BACKGROUND

Hepatitis B virus is a universal health problem. There are approximately 250 million people living with hepatitis B worldwide, and approximately 600000 of these people die every year due to the virus.

AIM

To compare the pretreatment and post-treatment histopathological results of patients with hepatitis be antigen (HBeAg)-negative chronic hepatitis B (CHB) who had been receiving tenofovir disoproxil fumarate (TDF) treatment at our clinic for at least 5 years.

METHODS

Patients with HBeAg-negative CHB who were being treated with TDF (245 mg/d) were included in the study. Liver biopsies of patients before TDF treatment and liver biopsies after 5 years of TDF treatment were retrospectively compared.

RESULTS

A total of 50 HBeAg-negative CHB patients were included in the study (mean age: 47.9 ± 10.4 years, men: 27.54%). Histological improvement was observed in 78% (39) of the patients after 5 years of treatment. After the 5 years of treatment, the mean Ishak score of the patients was 1.3 ± 1.3, and the mean histologic activity index score was 4.1 ± 2.8. A 1.53 point reduction in Ishak fibrosis score was detected after long-term TDF treatment.

CONCLUSION

Liver biopsies after 5 years of TDF treatment revealed a significant histological response and a regression of the necroinflammatory score compared to pretreatment liver biopsies. To better understand the effects of antiviral treatments on the improvement of liver histology, long-term studies involving larger numbers of patients are needed.

Keywords: Hepatitis B; Tenofovir; Chronic hepatitis; Biopsy; Liver; Fibrosis

Core Tip: Hepatitis B virus is a universal health problem. There are approximately 250 million people living with hepatitis B worldwide, and approximately 600000 of these people die every year due to the virus. Viral suppression with treatment can also lead to histological healing. In the current study, we aimed to compare the pretreatment and post-treatment histopathological results of patients with hepatitis be antigen-negative chronic hepatitis B who have been receiving tenofovir disoproxil fumarate (TDF) treatment at our clinic for at least 5 years. Liver biopsies after 5 years of TDF treatment revealed a significant histological response and a regression of the necroinflammatory score compared to pretreatment liver biopsies.