Treatment strategies using adefovir dipivoxil for individuals with lamivudine-resistant chronic hepatitis B

Tae Jung Yun, Jin Yong Jung, Chang Ha Kim, Soon-Ho Um, Hyonggin An, Yeon Seok Seo, Jin Dong Kim, Hyung Joon Yim, Bora Keum, Yong Sik Kim, Yoon Tae Jeen, Hong Sik Lee, Hoon-Jai Chun, Chang Duck Kim, Ho Sang Ryu

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

AIM: To investigate retrospectively the long-term efficacy of various treatment strategies using adefovir dipivoxil (adefovir) in patients with lamivudine-resistant chronic hepatitis B. METHODS: We included 154 consecutive patients in two treatment groups: the "add-on" group (n = 79), in which adefovir was added to ongoing lamivudine treatment due to lamivudine resistance, and the "switch/ combination" group (n = 75), in which lamivudine was first switched to adefovir and then re-added later as needed. The "switch/combination" group was then divided into two subgroups depending on whether participants followed (group A, n = 30) or violated (group B, n = 45) a proposed treatment strategy that determined whether to add lamivudine based on the serum hepatitis B virus (HBV) DNA levels (< 60 IU/mL or not) after 6 mo of treatment (roadmap concept). RESULTS: The cumulative probability of virologic response (HBV DNA < 60 IU/mL) was higher in group A than in the "add-on" group and in group B (P < 0.001). In contrast, the cumulative probability of virologic breakthrough was lower in the "add-on" group than in group B (P = 0.002). Furthermore, the risk of virologic breakthrough in the multivariate analysis was significantly lower in the "add-on" group than in group A (hazard ratio = 0.096; 95%CI, 0.015-0.629; P = 0.015). CONCLUSION: The selective combination of adefovir with lamivudine based upon early treatment responses increased the odds of virologic breakthrough relative to the use of uniform combination therapy from the beginning of treatment.

Original languageEnglish
Pages (from-to)6987-6995
Number of pages9
JournalWorld Journal of Gastroenterology
Volume18
Issue number47
DOIs
Publication statusPublished - 2012 Dec 1

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Lamivudine
Chronic Hepatitis B
Hepatitis B virus
Therapeutics
DNA
adefovir dipivoxil
Multivariate Analysis
Serum
adefovir

Keywords

  • Adefovir
  • Chronic hepatitis B
  • Combination therapy
  • Lamivudine-resistant
  • Roadmap concept

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Treatment strategies using adefovir dipivoxil for individuals with lamivudine-resistant chronic hepatitis B. / Yun, Tae Jung; Jung, Jin Yong; Kim, Chang Ha; Um, Soon-Ho; An, Hyonggin; Seo, Yeon Seok; Kim, Jin Dong; Yim, Hyung Joon; Keum, Bora; Kim, Yong Sik; Jeen, Yoon Tae; Lee, Hong Sik; Chun, Hoon-Jai; Kim, Chang Duck; Ryu, Ho Sang.

In: World Journal of Gastroenterology, Vol. 18, No. 47, 01.12.2012, p. 6987-6995.

Research output: Contribution to journalArticle

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AU - Yun, Tae Jung

AU - Jung, Jin Yong

AU - Kim, Chang Ha

AU - Um, Soon-Ho

AU - An, Hyonggin

AU - Seo, Yeon Seok

AU - Kim, Jin Dong

AU - Yim, Hyung Joon

AU - Keum, Bora

AU - Kim, Yong Sik

AU - Jeen, Yoon Tae

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AU - Chun, Hoon-Jai

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