| Adefovir dipivoxil is effective for the treatment of cirrhotic patients with lamivudine failure. | |
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MedLine Citation:
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PMID: 18795900 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: Data on the efficacy of adefovir dipivoxil (ADV) in elderly and cirrhotic patients with lamivudine-resistant (LAM-R) chronic hepatitis B are scarce. This retrospective cohort study evaluated the safety and efficacy of ADV in this specific patient population. METHODS: Sixty-eight cirrhotic LAM-R patients, of whom 19 (27.9%) were elderly (>or=65 years of age) and nine had severe disease (two post-orthotopic liver transplantation, four pre-orthotopic liver transplantation and three decompensated), with hepatitis B virus (HBV) infection received ADV. Virological and biochemical responses to the addition of ADV were analysed. RESULTS: At inclusion, all patients were receiving LAM; ADV was added. 75.4% of patients received a combination of LAM and ADV throughout this study for a median treatment duration of 12.6 months; the remainder received ADV with an overlap with LAM treatment for a median duration of 7.9 months. At the end of follow-up, 41.2% of patients had undetectable HBV DNA (<or=2000 copies/ml) with a median reduction of 3.4 log(10) copies/ml. Time to reach undetectable HBV DNA was dependent on baseline alanine aminotransferase (ALT) levels and HBeAg status. Normalization of serum ALT levels was observed in 55.2% (32/58) of patients. In patients who were HBeAg positive at baseline, HBeAg loss and seroconversion occurred in 23% (9/39) and 10% (4/39) respectively. No resistance mutations and no significant side effects were observed during the study period. CONCLUSION: Adefovir dipivoxil provides effective and safe treatment in cirrhotic and elderly patients who failed LAM therapy. |
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Authors:
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Fabien Zoulim; Parviz Parvaz; Patrick Marcellin; Jean-Pierre Zarski; Michel Beaugrand; Yves Benhamou; François Bailly; Marianne Maynard; Christian Trepo; Aldo Trylesinski; Françoise Monchecourt; |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2008-09-15 |
Journal Detail:
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Title: Liver international : official journal of the International Association for the Study of the Liver Volume: 29 ISSN: 1478-3231 ISO Abbreviation: Liver Int. Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-09 Completed Date: 2009-06-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101160857 Medline TA: Liver Int Country: England |
Other Details:
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Languages: eng Pagination: 420-6 Citation Subset: IM |
Affiliation:
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INSERM, U871, Lyon, France. fabien.zoulim@inserm.fr |
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 Aged Alanine Transaminase / metabolism Cohort Studies Drug Resistance / physiology Female Genotype Hepatitis B e Antigens / metabolism Hepatitis B virus / genetics Hepatitis B, Chronic / complications* Humans Lamivudine Liver Cirrhosis / drug therapy*, etiology Male Middle Aged Phosphonic Acids / therapeutic use* Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Hepatitis B e Antigens; 0/Phosphonic Acids; 134678-17-4/Lamivudine; 142340-99-6/adefovir dipivoxil; 73-24-5/Adenine; EC 2.6.1.2/Alanine Transaminase |
| Investigator | |
Investigator/Affiliation:
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N Boyer / ; V Esnault / ; Y Calmus / ; D Houssin / ; A Rosenberg / ; D Dhumeaux / ; C Hezode / ; M Bouvier-Alias / ; S Pol / ; A Nalpas / ; T Poynard / ; Y Benhamou / ; V Thibault / ; R Poupon / ; L Serfaty / ; Y Gozlan / ; G Pialoux / ; J D Grange / ; M Ahloulay / ; M Beaugrand / ; N Ganne / ; Y Baazia / ; J Fournet / ; A Plages / ; M Bourlière / ; L Lecomte / ; R Deydier / ; J F Cadranel / ; P Dumouchel / ; P Couzigou / ; J Foucher / ; L Castera / ; I Grange / ; J P Bronowicki / ; L Tricon / ; V Venard / ; E Lerebours / ; O Goria / ; C Chefson / ; P Baladaud / ; P H Bernard / ; A C Jouvencel / ; K Barange / ; J P Vinel / ; M Jaafar / ; M Kazatchkine / ; A Aouba / ; P Tisserand / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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