| Add-on adefovir is superior to a switch to entecavir as rescue therapy for Lamivudine-resistant chronic hepatitis B. | |
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MedLine Citation:
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PMID: 21253834 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: Lamivudine (LAM) has been extensively used to treat hepatitis B, but high incidence of drug resistance has required rescue studies. We validated the optimum treatment strategy for LAM-resistant patients by means of a comparative study of add-on adefovir (ADV) and a switch to entecavir (ETV). METHODS: We assessed the virologic response in consecutive LAM-resistant patients who received add-on ADV or a switch to ETV. RESULTS: The mean reduction of serum hepatitis B virus (HBV) DNA levels was significantly less in the ETV group than in the add-on ADV group (-3.45 vs. -4.17; P = 0.047 at week 24 and -3.81 vs. -4.68 log(10) IU/mL; P = 0.044 at week 48). Achievement of undetectable HBV DNA was significantly lower in the ETV group than in the add-on ADV group (P = 0.043). Multivariate analysis showed that add-on ADV, baseline HBV DNA levels, and initial virologic response were significant predictors of HBV DNA negativity (adjusted OR, 2.582; P = 0.008, 0.304; P = 0.001, and 5.928; P = 0.001). Virologic breakthrough was observed for 12 patients, in the ETV group only. CONCLUSIONS: Add-on ADV was more effective and durable than ETV as rescue therapy. Therefore, add-on ADV might be the preferred strategy for LAM-resistant patients who need long-term antiviral treatment. |
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Authors:
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Goh Eun Chung; Won Kim; Kook Lae Lee; Sang Youn Hwang; Jeong-Hoon Lee; Hwi Young Kim; Yong Jin Jung; Donghee Kim; Ji Bong Jeong; Byeong Gwan Kim; Yoon Jun Kim; Jung-Hwan Yoon; Hyo-Suk Lee |
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Publication Detail:
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Type: Journal Article Date: 2011-01-21 |
Journal Detail:
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Title: Digestive diseases and sciences Volume: 56 ISSN: 1573-2568 ISO Abbreviation: Dig. Dis. Sci. Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-13 Completed Date: 2011-08-17 Revised Date: 2011-09-14 |
Medline Journal Info:
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Nlm Unique ID: 7902782 Medline TA: Dig Dis Sci Country: United States |
Other Details:
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Languages: eng Pagination: 2130-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenine
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analogs & derivatives*,
therapeutic use Adult Antiviral Agents / therapeutic use* DNA, Viral / blood Drug Resistance, Viral Drug Therapy, Combination Female Guanine / analogs & derivatives*, therapeutic use Hepatitis B e Antigens / blood Hepatitis B virus / drug effects Hepatitis B, Chronic / blood, drug therapy* Humans Lamivudine / therapeutic use* Male Middle Aged Phosphonic Acids / therapeutic use* Retrospective Studies Reverse Transcriptase Inhibitors / therapeutic use* Treatment Outcome Viral Load / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Antiviral Agents; 0/DNA, Viral; 0/Hepatitis B e Antigens; 0/Phosphonic Acids; 0/Reverse Transcriptase Inhibitors; 0/entecavir; 106941-25-7/adefovir; 134678-17-4/Lamivudine; 73-24-5/Adenine; 73-40-5/Guanine |
| Comments/Corrections | |
Erratum In:
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Dig Dis Sci. 2011 Aug;56(8):2509 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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