aims: We conducted the first study on the safety and consequences of TDF discontinuation in the Iranian population with hepatitis B, yielding notable and insightful results. background: A limited number of studies have explored resistance and response to Tenofovir Disoproxil Fumarate in Iranian patients—a country with low HBV endemicity—none have investigated the outcomes of discontinuing treatment in eligible patients. objective: We conducted the first study on the safety and consequences of TDF discontinuation in the Iranian population with hepatitis B, yielding notable and insightful results. method: In this study, 44 patients with chronic hepatitis B who met the criteria for treatment cessation were recruited from the hepatitis clinic of a referral hospital in Tehran. Their data were collected and monitored over a 12-month follow-up period. Demographic information, duration of HBV diagnosis, and years of TDF treatment, were gathered using a questionnaire. Clinical and laboratory data were recorded every three months. If viral load or liver enzyme levels increased during the follow-up, in accordance with clinical guidelines, treatment was resumed. result: The analysis of the patients demographic data revealed that the mean age of individuals eligible to discontinue TDF treatment was 53.4 years, with a standard deviation of 12.5 years. The study findings revealed that the mean duration of hepatitis from diagnosis was 10.1 ± 5.3 years, while the mean duration of TDF treatment was 5.4 ± 1.3 years. By the ninth month, 70.5% (31 patients) had successfully discontinued TDF, while 34.1% (14 patients) failed to maintain cessation. At the twelfth month, 50% (22 patients) had successfully completed TDF discontinuation. A significant association was observed between the duration of hepatitis and TDF treatment and the likelihood of treatment discontinuation failure (P-value = 0.04 for both). Additionally, a significant difference in viral load was noted before and after TDF cessation at the twelfth month (P-value = 0.002). The twelfth-month viral load also significantly differed between the treatment failure and successful cessation groups (P-value = 0.005). conclusion: It is recommended that in cases with very high viral loads prior to TDF treatment, discontinuation should be approached with caution or avoided altogether. other: Additionally, TDF discontinuation should either be closely monitored or avoided in patients with a prolonged history of HBV or extended duration of TDF therapy.
Hajiabdolbaghi et al. (Fri,) studied this question.