Lu JC, Liu LG, Lin L, Zheng SQ, Xue Y. Incident hepatocellular carcinoma developing during tenofovir alafenamide treatment as a rescue therapy for multi-drug resistant hepatitis B virus infection: A case report and review of the literature. World J Clin Cases 2018; 6(13): 671-674 [PMID: 30430123 DOI: 10.12998/wjcc.v6.i13.671]
Corresponding Author of This Article
Yuan Xue, PhD, Chief Doctor, Department of Liver Diseases, the Third People’s Hospital of Changzhou, No. 300, Lanling North Road, Changzhou 213000, Jiangsu Province, China. xueyuan80908@163.com
Research Domain of This Article
Pharmacology & Pharmacy
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Clin Cases. Nov 6, 2018; 6(13): 671-674 Published online Nov 6, 2018. doi: 10.12998/wjcc.v6.i13.671
Incident hepatocellular carcinoma developing during tenofovir alafenamide treatment as a rescue therapy for multi-drug resistant hepatitis B virus infection: A case report and review of the literature
Jian-Chun Lu, Long-Gen Liu, Lin Lin, Shu-Qin Zheng, Yuan Xue
Jian-Chun Lu, Long-Gen Liu, Shu-Qin Zheng, Yuan Xue, Department of Liver Diseases, the Third People’s Hospital of Changzhou, Changzhou 213000, Jiangsu Province, China
Jian-Chun Lu, Long-Gen Liu, Lin Lin, Shu-Qin Zheng, Yuan Xue, Institute of Hepatology, the Third People’s Hospital of Changzhou, Changzhou 213000, Jiangsu Province, China
Lin Lin, Department of Pharmacy, the Third People’s Hospital of Changzhou, Changzhou 213000, Jiangsu Province, China
Author contributions: Xue Y designed the research; Lu JC, Liu LG, Lin L and Zheng SQ collected and confirmed the data; Lu JC wrote the manuscript; Xue Y revised the manuscript.
Supported by the Chinese Foundation for Hepatitis Prevention and Control- WBE Liver Fibrosis Foundation, No. WBE20161013; and the Science and Technology project of Changzhou, No. CJ20160024 and No. CJ20179030.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: All authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Yuan Xue, PhD, Chief Doctor, Department of Liver Diseases, the Third People’s Hospital of Changzhou, No. 300, Lanling North Road, Changzhou 213000, Jiangsu Province, China. xueyuan80908@163.com
Telephone: +86-519-82008326 Fax: +86-519-82009010
Received: July 24, 2018 Peer-review started: July 24, 2018 First decision: August 30, 2018 Revised: September 5, 2018 Accepted: October 12, 2018 Article in press: October 12, 2018 Published online: November 6, 2018 Processing time: 105 Days and 22.3 Hours
Abstract
Tenofovir disoproxil fumarate (TDF) is a potent nucleotide analogue with high barrier to resistance, which is recommended for multi-drug resistant hepatitis B virus (HBV) infection. However, nephrotoxicity has been reported during TDF treatment, and tenofovir alafenamide (TAF), which has comparable efficacy to TDF and improves bone and renal safety, can be used as a replacement strategy. Herein, we describe a clinical case concerning a 60-year-old individual suffering liver cirrhosis and renal dysfunction, and being infected with multidrug-resistant HBV. When failing treatment with TDF, he received TAF as a rescue therapy. TAF effectively inhibited HBV replication without worsening renal function or serum phosphorus abnormality. Furthermore, hepatocellular carcinoma (HCC) occurred during TAF treatment despite controlling the viral load. The risk of HCC could not be eliminated and should be monitored during TAF treatment.
Core tip: Tenofovir alafenamide rescues multidrug resistance and renal dysfunction in an old patient but does not eliminate the risk of hepatocellular carcinoma (HCC) development. Despite controlling the viral load, risk of HCC exists and should be monitored in cirrhotic patients.
