New advances in the treatment of chronic hepatitis B

The article was written by Dr. BSc Dinh The Trung - Hepatobiliary specialist, Vinmec Central Park International General Hospital and MSc.BSCKII Phan Thi Minh Huong - Gastroenterologist, Vinmec Danang International General Hospital .

What is hepatitis B Chronic hepatitis B (VGSV B) is a long-term infection with the hepatitis B virus that takes place inside the liver cells. The disease is transmitted through: the way through the skin (injection, blood transfusion, surgery, scratches...), unprotected sex with an infected person, the infected mother transmits the infection to her baby. Vietnam is considered one of the countries with the highest rate of chronic HBV infection in the world, estimated at 10-15% of the population. The disease can have serious and fatal health consequences from complications such as hepatitis flares, cirrhosis, and liver cancer. This is really an important burden on public health.

Tenofovir - first choice for the treatment of chronic HCV
Previously, Tenofovir disoproxil fumarate (TDF) was one of the most effective drugs for the treatment of chronic HBV. However, in rare cases, TDF can cause kidney and bone side effects such as kidney failure, decreased bone density, and osteoporosis. Because patients have to take the medicine for a long time, they are often concerned about these side effects. The good news for chronic hepatitis B patients is that at the end of 2016, the US Food and Drug Administration (FDA) approved the new generation Tenofovir (Tenofovir alafenamide, TAF) with high efficacy and safety. on kidney and bone compared with older generation TDF.
TDF and TAF are both prodrugs of Tenofovir, but TAF can enter hepatocytes more efficiently than TDF. Clinical studies have shown that only approximately ten times less TAF is needed to be used than TDF (for the treatment of chronic hepatitis B, the daily dose of TAF is one 25 mg tablet, whereas for TDF it is one 25 mg tablet, whereas for TDF it is a 25 mg tablet). need to take one 300 mg tablet) still produced a viral killing effect in hepatocytes comparable to TDF, but caused less adverse effects on the kidneys and bones because these organs were exposed to the amount of Tenofovir in the liver. much less blood. Because of its high safety and effectiveness, in April 2017, the European Association for the Study of Liver Diseases recommended TAF as one of the first-line options for the treatment of chronic HBV infection, especially in the elderly, those who People with chronic kidney disease, osteoporosis, reduced bone density or at risk of osteoporosis.
Another good news, TAF drug is available in developing countries after Gilead pharmaceutical company (USA) allowed Indian pharmaceutical companies to produce TAF drug with good quality but at reasonable price. for patients in these countries.