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

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.

• Authors: Soon Sun Kim, Jae Youn Cheong, Dami Lee, Myoung Hee Lee, Sun Pyo Hong, Soo-Ok Kim, Sung Won Cho
• Journal: Journal of medical virology (J Med Virol) Vol. 84 Issue 1 Pg. 18-25 (Jan 2012) ISSN: 1096-9071 [Electronic] United States
• PMID: 22028068 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Wiley Periodicals, Inc.

Chemical References

• Antiviral Agents
• DNA, Viral
• Organophosphonates
• Lamivudine
• entecavir
• Guanine
• adefovir
• Adenine

Topics

• Adenine (administration & dosage, analogs & derivatives)
• Adult
• Antiviral Agents (administration & dosage)
• DNA, Viral (blood)
• Drug Resistance, Viral
• Drug Therapy, Combination (methods)
• Guanine (administration & dosage, analogs & derivatives)
• Hepatitis B, Chronic (drug therapy, virology)
• Humans
• Lamivudine (administration & dosage)
• Male
• Middle Aged
• Organophosphonates (administration & dosage)
• Treatment Outcome
• Viral Load