We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Rescue therapy for lamivudine-resistant chronic hepatitis B: Comparison between entecavir 1.0 mg monotherapy, adefovir monotherapy and adefovir add-on lamivudine combination therapy.
- Authors
Kim, Hong Joo; Park, Jung Ho; Park, Dong Il; Cho, Yong Kyun; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik
- Abstract
Background and Aim: There have been no reports comparing the therapeutic results of adefovir (ADV) and entecavir (ETV) rescue therapy for patients with lamivudine (LAM)-resistant chronic hepatitis B (CHB). We aimed to compare the cumulative efficacy and resistance of ETV 1.0 mg monotherapy, ADV monotherapy and ADV add-on LAM combination therapy in LAM-refractory patients. Methods: One hundred and four patients were included in the following three treatment groups; group 1 ( n = 24), LAM was switched to ETV (1.0 mg once a day); group 2 ( n = 44), LAM was switched to ADV (10 mg once a day); and group 3 ( n = 36), ADV was added to LAM (10 mg once a day). Results: After 6 months of rescue treatment, alanine aminotransferase normalization was observed in 75.0%, 65.9% and 74.3% of patients receiving ETV monotherapy, ADV monotherapy and ADV add-on therapy, respectively. A significantly higher log10HBV-DNA drop at 6 months occurred in the ADV add-on group compared with the ETV group. The rate of HBV-DNA polymerase chain reaction undetectability (<300 copies/mL) 6 months after initiation of ETV monotherapy, ADV monotherapy and ADV add-on therapy was 33.3%, 27.3% and 68.6%, respectively ( P = 0.003). The cumulative HBeAg seroconversion rate was significantly higher in ADV add-on/ADV monotherapy groups compared with the ETV monotherapy group ( P = 0.022). Viral breakthrough and genotypic resistance were detected in six (25.0%) and six (13.6%) patients in the ETV and ADV monotherapy groups, whereas no cases of genotypic resistance were detected in ADV add-on group 24 months after initiation of antiviral treatment ( P < 0.01). Conclusion: Adefovir add-on treatment in patients with LAM-resistant CHB suppresses HBV replication more effectively than ETV or ADV monotherapy. Additionally, no genotypic resistance was detected in the ADV add-on group.
- Subjects
HEPATITIS B treatment; LAMIVUDINE; COMBINATION drug therapy; DNA polymerases; LIVER diseases; COHORT analysis; PATIENTS; THERAPEUTICS
- Publication
Journal of Gastroenterology & Hepatology, 2010, Vol 25, Issue 8, p1374
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/j.1440-1746.2010.06381.x