A short course of add-on adefovir dipivoxil treatment in lamivudine-resistant chronic hepatitis B patients

The aims of the study were to investigate the efficacy of rescue therapy with lamivudine (LAM) and adefovir (ADV) combination for 6 months followed by ADV monotherapy in lamivudine‐resistant chronic hepatitis B (LAM‐R CHB) patients, and to analyze the frequency of ADV resistance mutant development i...

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Bibliographic Details
Published in:Journal of viral hepatitis 2009-04, Vol.16 (4), p.279-285
Main Authors: Idilman, R., Kaymakoglu, S., Oguz Onder, F., Ahishali, E., Bektas, M., Cinar, K., Pınarbasi, B., Karayalcin, S., Badur, S., Cakaloglu, Y., Mithat Bozdayi, A., Bozkaya, H., Ökten, A., Yurdaydin, C.
Format: Article
Language:English
Subjects:
adefovir
Adenine - analogs & derivatives
Adenine - pharmacology
Adenine - therapeutic use
Adult
Amino Acid Substitution - genetics
Antiviral Agents - pharmacology
Antiviral Agents - therapeutic use
DNA, Viral - blood
DNA, Viral - genetics
Drug Resistance, Viral
Female
Hepatitis B e Antigens - blood
hepatitis B virus
Hepatitis B virus - drug effects
Hepatitis B, Chronic - drug therapy
Humans
lamivudine
Lamivudine - pharmacology
Male
Middle Aged
Mutation, Missense
Organophosphonates - pharmacology
Organophosphonates - therapeutic use
resistance
Salvage Therapy - methods
Sequence Analysis, DNA
Treatment Outcome
Viral Load
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Summary:The aims of the study were to investigate the efficacy of rescue therapy with lamivudine (LAM) and adefovir (ADV) combination for 6 months followed by ADV monotherapy in lamivudine‐resistant chronic hepatitis B (LAM‐R CHB) patients, and to analyze the frequency of ADV resistance mutant development in such patients. A total of 170 consecutive LAM‐R CHB patients (male/female: 130/40, mean age: 42.9 ± 13.4 years) with viral breakthrough under LAM therapy were analyzed. A total of 68 had HBeAg‐positive. Patients received rescue therapy with LAM [100 mg (qd)]+ADV [10 mg (qd)] for 6 months after which LAM was discontinued. HBV‐DNA was assessed with the HBV‐DNA 3.0 bDNA assay. ADV‐resistant mutations were identified by sequencing the reverse transcriptase region. The median duration of rescue therapy was 24 months. Cumulative probability of becoming HBV‐DNA undetectable was 33.8%, 59.6% and 68.2% after 24, 48 and 96 weeks of treatment, respectively. These figures were 43.2%, 58.0% and 73.1% for ALT normalization. Among 68 HBeAg‐positive CHB patients, 10 patients had an e‐antigen seroconversion. Low baseline HBV‐DNA level (
ISSN:1352-0504
1365-2893
DOI:10.1111/j.1365-2893.2009.01074.x