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Low efficacy of entecavir therapy in adefovir-refractory hepatitis B patients with prior lamivudine resistance.

Authors
Cho, SW; Koh, KH; Cheong, JY; Lee, MH; Hong, SP; Yoo, WD; Kim, SO
Citation
Journal of viral hepatitis, 17(3):171-177, 2010
Journal Title
Journal of viral hepatitis
ISSN
1352-05041365-2893
Abstract
We determined the virologic response, incidence of entecavir resistance, and evolution of lamivudine and adefovir-resistant mutants during entecavir (ETV) therapy in adefovir-refractory patients with prior lamivudine resistance. Forty adefovir-refractory chronic hepatitis B patients with prior lamivudine resistance who had received entecavir for > or = 6 months were included and monitored for virologic response and entecavir resistance. Ten per cent of patients achieved HBV DNA < 50 copies/mL by PCR after 24 weeks of ETV therapy, and an initial virologic response was observed in 12 of 40 patients (30%). Higher pretreatment ALT (P = 0.039) and the presence of the rtL180M mutation (P = 0.038) were associated with an initial virologic response. During a mean follow-up of 11.4 months, four patients (10%) experienced virologic breakthrough, while ETV-resistant mutants were detected in six patients (15%). YMDD and adefovir-resistant mutants were detected in 57 and 35% of patients at baseline, respectively. At 48 weeks of therapy, 96 and 4% of patients had YMDD and adefovir-resistant mutants, respectively. These data suggest an early development of ETV resistance and low antiviral response during ETV therapy in adefovir-refractory patients with prior lamivudine resistance.
MeSH terms
Adenine/*analogs & derivatives/pharmacologyAdultAntiviral Agents/pharmacology/*therapeutic useDNA, Viral/blood*Drug Resistance, ViralFemaleFollow-Up StudiesGuanine/*analogs & derivatives/therapeutic useHepatitis B virus/*drug effectsHepatitis B, Chronic/*drug therapy/virologyHumansLamivudine/*pharmacologyMaleMiddle AgedPhosphonic Acids/*pharmacologyTreatment OutcomeViral Load
DOI
10.1111/j.1365-2893.2009.01161.x
PMID
19678894
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
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