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Tenofovir Treatment Hepatitis B

Tenofovir Treatment Hepatitis B


Tenofovir disoproxil fumarate is a nucleotide analog reverse transcriptase inhibitor recently approved by the United States Food and Drug Administration (FDA) for the treatment of chronic hepatitis B virus (HBV) infection in adults.

Tenofovir has been available in the United States for the treatment of human immunodeficiency virus (HIV) since 2001. It blocks HBV replication in liver cells and is available as a once-daily oral formulation. The efficacy of tenofovir for the treatment of chronic HBV has been demonstrated to be superior to adefovir in randomized controlled trials, which led to its FDA approval for use in chronic HBV.

Because of its potent antiviral activity, favorable safety profile, and higher barrier to the development of resistance, tenofovir should replace adefovir as a first-line monotherapy option in the treatment of HBV in monoinfected patients.

In the HIV-HBV-coinfected population, tenofovir is already a preferred agent in combination with other anti-HBV agents (lamivudine or emtricitabine), which are cotreatments for HIV as well. In addition, tenofovir monotherapy or in combination with nucleoside analogs are options for patients who have developed resistance to other therapies for chronic HBV, including lamivudine and adefovir.

People with acute hepatitis B do not require treatment. Rest, drinking lots of fluids and maintaining adequate nutrition are usually all that is needed to manage acute hepatitis B symptoms. In severe cases, hospitalization may be necessary, but this is rare.

Chronic hepatitis B is not curable, but it is treatable. The goal of therapy is to reduce the risk of complications, including premature death.

Tenofovir is an antiviral medicine. It belongs to a group of medicines known as nucleoside reverse transcriptase inhibitors (NRTIs).

 virus which is carried in your bloodstream to your liver, where it can cause inflammation and damage. Following infection with hepatitis B, a few people develop a persistent infection called chronic hepatitis B, and will usually need treatment to reduce the activity of the virus. This limits damage to the liver, which is a complication of the infection.

Antiviral medicines like tenofovir work by stopping the hepatitis B virus from multiplying (replicating), this reduces the amount of the virus in your body. A doctor who is a liver specialist will usually start the treatment for you. Treatment for chronic hepatitis B usually continues for several years and can include more than one antiviral medicine.

Tenofovir is also prescribed for another viral infection - there is more information about this in a separate medicine leaflet.

How to take tenofovir for hepatitis B infection

  • Before you start the treatment, read the manufacturer's printed information leaflet from inside your pack. It will give you more information about tenofovir, and it will also provide you with a full list of the side-effects which you could experience from taking it.
  • Take tenofovir exactly as your doctor tells you to. The usual dose is one 245 mg tablet daily. For anyone who is unable to take tablets, tenofovir is also available as granules. These are measured out using the dosing scoop provided, and then taken mixed into a soft food such as yoghurt or apple sauce. Mix each scoopful of granules with a tablespoon (15 ml) of food. Do not chew the granules/food mixture as you swallow it as it will taste bitter. Please note, the granules must not be mixed with liquids or drinks. Your doctor will advise you about how many scoopfuls of granules you should take for each dose.
  • Swallow the tablet whole with a drink of water. If you have difficulty swallowing tablets, please let your doctor know about this as it may be more suitable for you to be prescribed tenofovir as granules. In the meantime, if necessary, you can crush the tablet and add it to half a glass of water, orange juice or grape juice, providing you swallow it straightaway.
  • Try to take tenofovir at the same time of day each day, as this will help you to remember to take it regularly. Take it with a meal or a snack.
  • If you forget to take a dose, take it as soon as you remember, providing it is within the next 12 hours. If it is more than 12 hours later when you remember, leave out the missed dose but do remember to take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

  • Keep your regular appointments with your doctor so that your progress can be monitored. You will need to have some blood tests from time to time.
  • It is important that you continue to take tenofovir regularly. Treatment for hepatitis B can be long-term. Continue to take tenofovir until you are advised otherwise by your doctor, even if you feel well.
  • Most people with chronic hepatitis B will be advised to eat a normal healthy balanced diet. However, it is likely you will be advised not to drink alcohol. Alcohol will increase the risk and speed of you developing liver damage.
  • Treatment with this medicine does not stop you from passing the infection on to others through sexual contact, sharing needles to inject drugs, or from mother to baby. A vaccine is available which protects against hepatitis B and can be offered to your sexual and household contacts who are at risk of being infected. Do not have sex with anyone (especially any sex without using a condom) until they have been fully immunised and have had their blood checked to see that the immunisation has worked.
  • Tenofovir has been associated with a serious side-effect in some people who have taken it. This is known as lactic acidosis. It is a problem where there is too much lactic acid in the blood. The symptoms associated with it are listed in the next section 'Can tenofovir cause problems?'. If you develop any of the symptoms listed below, you must let your doctor know straightaway, as they can worsen, and may even become life-threatening.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • If you buy any medicines, supplements or herbal remedies 'over the counter', check with a pharmacist that they are suitable to take with tenofovir and your other medicines.

How It Works

HBV is a noncytopathic virus, which means the virus itself does not directly damage the liver. Rather, when the body is infected with HBV, the immune system mounts an assault on the virus and causes collateral damage in the form of inflammation and damage to the liver. Tenofovir is part of a class of medications known as nucleoside reverse transcriptase inhibitors . These work by decreasing the amount of the hepatitis B virus in the blood, which in turn keeps the immune response at bay. It will not cure hepatitis B, may not prevent complications of the disease such as cirrhosis of the liver or liver cancer, and will not prevent the spread of the virus to others.

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