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Efficacy of Tenofovir in Patients with Acute Chronic Hepatitis B liver Failure

Original Research Article Background: The effectiveness of nucleoside analogue (NA) treatment in patients with chronic hepatitis B (CHB) associated liver failure is still controversial. Severe lactic acidosis has been reported during entecavir (ETV) treatment in patients with impaired liver function. Aim: To investigate the rescuing efficacy and safety of ETV in patients with CHB-associated liver failure. Methodology: In this study a total of 32 acute on chronic Hepatitis B liver failure patients (age > 18 years with both sexes but male predominant) were included in Hepatology department of Bangabandhu Sheikh Mujib Medical University, Dhaka during January 2013 to December 2015. The patients were randomized into two groups: Tenofovir group (N=16) and Entecavir group (n=32) and followed at least for 03 months. Result: It was observed that more than two third (68.8%) patients belonged to age ≤50 years in tenofovir group. The mean age was found 43.8±13.1 years in tenofovir. The mean difference was not statistically significant (p>0.05) of tenofovir. Altered level of consciousness was found 10(87.5%) in tenofovir group. Moderate ascites was found 11(68.8%) in tenofovir group. Encephalopathy was found 10(62.5%) in tenofovir group. The tenofovir was not statistically significant (p>0.05). It was observed that mean total countwas found 10580.0±4818.6 /mm 3 in tenofovir group Mean serum bilirubinwas found 19.8±7.4 mg/dl in tenofovir group. Mean Rank ALT was found 15.0 U/L in tenofovir group. Mean Rank AST was found 15.2 U/L in tenofovir group. Mean prothrombin time was found 22.1±3.3 second in tenofovir group. Mean international normalized ratio was found 1.9±0.3 in tenofovir group. Mean serum albumin was found 2.1±0.6 gm/dl in tenofovir group. Mean serum creatinine was found 0.98±0.27 mg/dl in tenofovir group. Mean serum sodium was found 133.4±5.3 mmol/l in tenofovir. Mean serum potassium was found 4.1±0.7 mmol/l in tenofovir group. Mean MELD score was found 25.0±3.1 in tenofovir group. Mean Child Pugh scorewas found 12.1±1.3 in tenofovir group. The mean difference were not statistically significant (p>0.05) of tenofovir. HBeAg was found 12(37.5%) patients in tenofovir group. HBV DNA was found 16(50.0%) patients belonged to HBV DNA>20000 IU/ml in tenofovir group. Mean Rank HBV DNA was found 16.8 IU/ml in tenofovir group. The in tenofovir was not statistically significant (p>0.05). Conclusion: For some people, Hepatatis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure liver cancer or cirrhosis a condition that permanently scars of the liver. Tenofovir can treat hepatitis B very effectively in some people. In some situations, tenofovir is more effective. Research suggests tenofovir is a safe and effective long term reatment.