Abstract |
Adefovir dipivoxil (ADV)-resistant mutations have been identified in treating hepatitis B virus (HBV) infection. This study aimed to analyze the response, the incidence of ADV resistance and the virologic characteristics of ADV therapy. A total of 29 CHB patients with confirmed lamivudine ( LAM)-resistant HBV were treated with ADV for more than 52 weeks. Serum HBV DNA, HBV genotypes and sequences of HBV polymerase reverse-transcriptase domain were determined. Rates for the biochemical response, HBeAg loss, HBeAg seroconversion and virologic response (< 200 copies/mL of HBV DNA) were 82.8, 23.5, 11.8, and 48.3%, respectively, at week 52 of treatment. Lower pre-treatment mean HBV DNA level was the only significant factor associated with negative HBV DNA after ADV therapy. Six (20.7%) patients had clearance of LAM-resistant YMDD variants with replacement by the wild type HBV at week 52. The rtN236T, rtA181V/T and rtI233V were not identified before ADV therapy and the genotypic mutation of rtN236T was detected in one (3.4%) patient. In conclusion, the 52-week ADV treatment for patients with LAM-resistant HBV variants significantly achieved normalization of ALT levels, reduced serum HBV DNA levels and induced HBeAg loss and seroconversion. The emergence of ADV-resistant mutations seemed rare at weeks 52.
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Authors | Chia-Yen Dai, Wan-Long Chuang, Ming-Yen Hsieh, Li-Po Lee, Jee-Fu Huang, Nai-Jen Hou, Zu-Yau Lin, Shinn-Cherng Chen, Ming-Yuh Hsieh, Liang-Yen Wang, Jun-Fa Tsai, Wen-Yu Chang, Ming-Lung Yu |
Journal | Antiviral research
(Antiviral Res)
Vol. 75
Issue 2
Pg. 146-51
(Aug 2007)
ISSN: 0166-3542 [Print] Netherlands |
PMID | 17400303
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Antibodies, Viral
- Antiviral Agents
- DNA, Viral
- Hepatitis B e Antigens
- Organophosphonates
- Reverse Transcriptase Inhibitors
- Lamivudine
- Creatinine
- Alanine Transaminase
- Adenine
- Bilirubin
- adefovir dipivoxil
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Topics |
- Adenine
(analogs & derivatives, pharmacology, therapeutic use)
- Adult
- Aged
- Alanine Transaminase
(blood)
- Antibodies, Viral
(blood)
- Antiviral Agents
(therapeutic use)
- Bilirubin
(blood)
- Creatinine
(blood)
- DNA, Viral
(blood, genetics)
- Drug Resistance, Viral
(genetics)
- Female
- Genotype
- Hepatitis B e Antigens
(blood)
- Hepatitis B virus
(drug effects, genetics, immunology)
- Hepatitis B, Chronic
(blood, drug therapy, virology)
- Humans
- Lamivudine
(pharmacology, therapeutic use)
- Male
- Middle Aged
- Mutation
- Organophosphonates
(pharmacology, therapeutic use)
- Reverse Transcriptase Inhibitors
(pharmacology, therapeutic use)
- Time Factors
- Treatment Outcome
- Viral Load
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