Document Detail


Add-on adefovir is superior to a switch to entecavir as rescue therapy for Lamivudine-resistant chronic hepatitis B.
MedLine Citation:
PMID:  21253834     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article     Date:  2011-01-21
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  56     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-13     Completed Date:  2011-08-17     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2130-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
Adenine / 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
Organophosphonates / therapeutic use*
Retrospective Studies
Reverse Transcriptase Inhibitors / therapeutic use*
Treatment Outcome
Viral Load / drug effects
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/DNA, Viral; 0/Hepatitis B e Antigens; 0/Organophosphonates; 0/Reverse Transcriptase Inhibitors; 0/entecavir; 134678-17-4/Lamivudine; 6GQP90I798/adefovir; 73-24-5/Adenine; 73-40-5/Guanine
Comments/Corrections
Erratum In:
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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