Rescue therapy with adefovir in decompensated liver cirrhosis patients with lamivudine-resistant hepatitis B virus.

Abstract

BACKGROUND/AIMS:

Adefovir dipivoxil (ADV) is a nucleotide analogue that is effective against lamivudine-resistant hepatitis B virus (HBV). The aim of this study was to determine the long-term clinical outcomes after ADV rescue therapy in decompensated patients infected with lamivudine-resistant HBV.

METHODS:

In total, 128 patients with a decompensated state and lamivudine-resistant HBV were treated with ADV at a dosage of 10 mg/day for a median of 33 months in this multicenter cohort study.

RESULTS:

Following ADV treatment, 86 (72.3%) of 119 patients experienced a decrease in Child-Pugh score of at least 2 points, and the overall end-stage liver disease score decreased from 16±5 to 14±10 (mean ± SD, P<0.001) during the follow-up period. With ADV treatment, 67 patients (56.3%) had undetectable serum HBV DNA (detection limit, 0.5 pg/mL). Virologic breakthrough occurred in 38 patients (36.1%) and 9 patients had a suboptimal ADV response. The overall survival rate was 89.9% (107/119), and a suboptimal response to ADV treatment was associated with both no improvement in Child-Pugh score (≥2 points; P=0.001) and high mortality following ADV rescue therapy (P=0.012).

CONCLUSIONS:

Three years of ADV treatment was effective and safe in decompensated patients with lamivudine-resistant HBV.

• Authors: Hyun Young Woo, Jong Young Choi, Seung Kew Yoon, Dong Jin Suh, Seung Woon Paik, Kwang Hyub Han, Soon Ho Um, Byung Ik Kim, Heon Ju Lee, Mong Cho, Chun Kyon Lee, Dong Joon Kim, Jae Seok Hwang
• Journal: Clinical and molecular hepatology (Clin Mol Hepatol) Vol. 20 Issue 2 Pg. 168-76 (Jun 2014) ISSN: 2287-285X [Electronic] Korea (South)
• PMID: 25032183 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• DNA, Viral
• Hepatitis B e Antigens
• Organophosphonates
• Lamivudine
• adefovir
• Adenine

Topics

• Adenine (analogs & derivatives, therapeutic use)
• Adult
• Aged
• Antiviral Agents (therapeutic use)
• Cohort Studies
• DNA, Viral (blood)
• Drug Resistance, Viral
• Female
• Hepatitis B (complications, drug therapy)
• Hepatitis B e Antigens (blood)
• Hepatitis B virus (genetics)
• Humans
• Lamivudine (therapeutic use)
• Liver Cirrhosis (diagnosis, etiology, mortality)
• Male
• Middle Aged
• Odds Ratio
• Organophosphonates (therapeutic use)
• Retrospective Studies
• Severity of Illness Index
• Survival Rate