Comparison of lamivudine plus adefovir therapy versus entecavir with or without adefovir therapy for adefovir-resistant chronic hepatitis B

Seong Hee Kang, Hyung Joon Yim, Hae Rim Kim, Keunhee Kang, Sang Jun Suh, Hyun Jung Lee, Eileen L. Yoon, Ji Hoon Kim, Yeon Seok Seo, Jong Eun Yeon, Kwan Soo Byun

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6 Citations (Scopus)

Abstract

Background and Goals: Data regarding the management of adefovir (ADV) resistance are still limited. The aim of this study is to investigate treatment outcomes of rescue therapy in ADV-resistant chronic hepatitis B (CHB) patients.

Study: CHB patients who began rescue therapy due to documented genotypic resistance mutations to ADV between October 2006 and July 2012 were retrospectively reviewed.

Results: Sixty-three patients were included in this study. Most patients had history of lamivudine (LAM) resistance. Treatment response was evaluated at 3-month intervals up to 12 months. The cumulative rate of complete virologic response (CVR) in hepatitis B virus (HBV)-infected patients (HBV DNA<60 IU/mL) was 15.9%, 27.2%, 28.9%, and 31.7% after 3, 6, 9, and 12 months of rescue therapy. Thirty-five patients were treated with a combination of LAM plus ADV (LAM+ADV group) and 28 patients were treated with entecavir (ETV)-based therapy (ETV with or without ADV therapy, ETV±ADV group). The cumulative CVR rate was significantly higher in the ETV±ADV group than in the LAM+ADV group at month 12 (46.4% vs. 20.6%, respectively, P=0.040). Multivariate analysis showed that pretreatment serum HBV DNA levels at <6log10 IU/mL (hazard ratio: 34.109, P=0.001) and type of rescue therapy (hazard ratio: 4.944, P=0.036) were associated with CVR.

Conclusions: Lower baseline HBV DNA level and ETV±ADV therapy were the important predictive factors for CVR in ADVresistant CHB patients. This study suggests the need of early switching to a rescue therapy such as ETV±ADV at the time of low-level viremia.

Original languageEnglish
Pages (from-to)889-895
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume48
Issue number10
Publication statusPublished - 2014 Dec 10

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Keywords

  • Adefovir
  • Chronic hepatitis B
  • Entecavir
  • Lamivudine
  • Resistance

ASJC Scopus subject areas

  • Gastroenterology

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