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Adefovir-based combination therapy with entecavir or lamivudine for patients with entecavir-refractory chronic hepatitis B

Authors
Kim, SS; Cheong, JY; Lee, D; Lee, MH; Hong, SP; Kim, SO; Cho, SW
Citation
Journal of medical virology, 84(1):18-25, 2012
Journal Title
Journal of medical virology
ISSN
0146-66151096-9071
Abstract
This study evaluated the efficacy of adefovir (ADV) plus lamivudine (LAM) or ADV add-on therapy for patients with entecavir (ETV)-refractory hepatitis B infection. Twenty-nine ETV-resistant and 8 patients with suboptimal response to ETV were enrolled. Twenty-seven patients received ADV + LAM therapy and 10 patients received ADV + ETV therapy for >24 weeks. In 29 patients who were ETV-resistant, the mean reduction in HBV DNA levels at 24 weeks was not different between the ADV + LAM and ADV + ETV groups (-1.98 log(10)  IU/ml vs. -2.16 log(10)  IU/ml; P = 0.792). Primary non-response was observed in 52.2% (12/23) of ADV + LAM group and 33.3% (2/6) of ADV + ETV group (P = 0.651). Initial virologic response (IVR) was observed in 17.4% (4/23) of ADV + LAM group and 33.3% (2/6) of ETV + ADV group (P = 0.362). In eight patients with suboptimal response to ETV, the ADV + ETV group had a greater reduction in HBV DNA at 24 and 48 weeks than the ADV + LAM group (-2.29 log(10)  IU/ml vs. -0.09 log(10)  IU/ml and -2.04 log(10)  IU/ml vs. -0.72 log(10)  IU/ml; P = 0.020 and P = 0.012, respectively). Primary non-response and IVR did not significantly differ between the two groups [100% (4/4) vs. 50% (2/4) and 0% (0/4) vs. 50% (2/4); P = 0.429 and P = 0.429, respectively]. The antiviral efficacies of ADV-based therapy with ETV or LAM for patients with ETV-resistant hepatitis B were limited and did not differ between the two groups. However, adding ADV to ETV may be more effective than ADV + LAM therapy in patients with suboptimal virologic response to ETV.
MeSH terms
Adenine/administration & dosage/*analogs & derivativesAdultAntiviral Agents/*administration & dosageDNA, Viral/bloodDrug Resistance, ViralDrug Therapy, Combination/methodsGuanine/administration & dosage/*analogs & derivativesHepatitis B, Chronic/*drug therapy/virologyHumansLamivudine/*administration & dosageMaleMiddle AgedOrganophosphonates/*administration & dosageTreatment OutcomeViral Load
DOI
10.1002/jmv.22227
PMID
22028068
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
AJOU Authors
김, 순선정, 재연이, 명희조, 성원
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