Treatment of lamivudine-resistant chronic hepatitis B infection: A multicenter retrospective study

Sun Jae Lee, Hyung Joon Yim, Seong Gyu Hwang, Yeon Seok Seo, Ji Hoon Kim, Eileen L. Yoon, Joong Min Lee, Bo Hyun Kim, Sang Jong Park, Young Min Park, Hong Soo Kim, Se Hwan Lee, Sang Hoon Ahn, Jeong Il Lee, Jin Woo Lee, In Hee Kim, Hyung Soo Kim, Sun Pyo Hong

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)

    Abstract

    Objectives. To compare the efficacy of rescue therapies in lamivudine (LAM)-resistant chronic hepatitis B (CHB) infections including: (1) adefovir dipivoxil (ADV) monotherapy, (2) ADV plus LAM combination therapy and (3) entecavir (ETV) 1.0 mg monotherapy. Materials and methods. The authors designed a multicenter-retrospective study. Eight institutions participated in the study from Korea. Results. A total of 343 LAM-resistant CHB patients were enrolled. The proportion of patients with undetectable serum hepatitis B virus (HBV) DNA levels at month 24 after the initiation of rescue therapy was higher in the ADV plus LAM combination therapy group (39/64, 60.9%) than in the ADV monotherapy (50/126, 39.7%) and ETV 1.0 mg monotherapy (19/48, 39.6%) groups (p = 0.014). Mean serum HBV DNA levels at 24 months were 2.07 ± 1.21 log10 IU/ml in the ADV plus LAM combination therapy group, 2.74 ± 1.74 log10 IU/ml in the ADV monotherapy group and 3.08 ± 1.97 log10 IU/ml in the ETV 1.0 mg monotherapy group (p = 0.014). In multivariate analysis, a finding of undetectable serum HBV DNA level at 6 months and ADV plus LAM combination therapy (vs. ADV) was an independent factor for predicting undetectable serum HBV DNA at month 24 (odds ratio, 1.003; 95% confidence interval, 1.000-1.006; p = 0.026). Conclusions. ADV plus LAM combination therapy is more effective in reducing viral load than switching to ADV or ETV 1.0 mg in patients with LAM-resistant CHB.

    Original languageEnglish
    Pages (from-to)196-204
    Number of pages9
    JournalScandinavian Journal of Gastroenterology
    Volume48
    Issue number2
    DOIs
    Publication statusPublished - 2013 Feb

    Keywords

    • Adefovir
    • Antiviral resistance
    • Chronic hepatitis B
    • Combination drug therapy
    • Entecavir
    • Lamivudine
    • Multicenter study

    ASJC Scopus subject areas

    • Gastroenterology

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