Abstract | GOAL: BACKGROUND:
LAM and adefovir (ADV) combination therapy should be recommended for an initial rescue therapy against LAM-resistant hepatitis B virus (HBV). However, there still are many LAM-resistant patients being treated with entecavir (ETV) or ADV monotherapy. STUDY: This retrospective cohort study included consecutive patients treated for LAM-resistant chronic hepatitis B with ETV or ADV monotherapy, or LAM/ADV combination therapy. The cumulative probabilities of GR and virological responses and breakthrough according to clinical variables were analyzed by survival analyses and derived an index for future GR. RESULTS: A total of 224 patients were included (median treatment duration=117.9 wk). Using risk factors indentified on multivariable analyses, a simple index for future GR ( Antiviral Resistance Prediction Index, ARPI) was developed with 3 clinical variables: the rescue therapy regimens (+0, ADV; +1, ETV; +2, LAM/ADV), HBV DNA reduction at 12 weeks (+0, <3 log10 copies/mL; +1, >3 log10 copies/mL), and the initial HBV DNA level (+0, >10 copies/mL; +1, <10 copies/mL). No patient with ARPI ≥2 exhibited GR, whereas 47% of the patients with an ARPI <2 developed GR by week 144 (P=0.005). CONCLUSIONS: The results of this study suggest that the ARPI is a simple and early index that can be used to determine the risk for subsequent GR during rescue therapy for LAM-resistant chronic hepatitis B.
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Authors | Jeong-Hoon Lee, Jung-Hwan Yoon, Eun Ju Cho, Hyo Joon Yang, Eun Sun Jang, Min-Sun Kwak, Sang Youn Hwang, Su Jong Yu, Chang-Hoon Lee, Yoon Jun Kim, Chung Yong Kim, Hyo-Suk Lee |
Journal | Journal of clinical gastroenterology
(J Clin Gastroenterol)
Vol. 46
Issue 3
Pg. 243-50
(Mar 2012)
ISSN: 1539-2031 [Electronic] United States |
PMID | 21716122
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antiviral Agents
- Organophosphonates
- Lamivudine
- entecavir
- Guanine
- adefovir
- Adenine
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Topics |
- Adenine
(analogs & derivatives, therapeutic use)
- Adult
- Aged
- Antiviral Agents
(pharmacology, therapeutic use)
- Cohort Studies
- Drug Resistance, Viral
(genetics)
- Drug Therapy, Combination
- Female
- Guanine
(analogs & derivatives, therapeutic use)
- Hepatitis B virus
(drug effects, genetics)
- Hepatitis B, Chronic
(drug therapy, mortality, virology)
- Humans
- Lamivudine
(pharmacology, therapeutic use)
- Male
- Middle Aged
- Organophosphonates
(therapeutic use)
- Predictive Value of Tests
- Retrospective Studies
- Survival Analysis
- Treatment Outcome
- Young Adult
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