Document Detail


Adefovir dipivoxil is effective for the treatment of cirrhotic patients with lamivudine failure.
MedLine Citation:
PMID:  18795900     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2008-09-15
Journal Detail:
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:
Created Date:  2009-03-09     Completed Date:  2009-06-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  420-6     Citation Subset:  IM    
Affiliation:
INSERM, U871, Lyon, France. fabien.zoulim@inserm.fr
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adenine / 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:
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:
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


Previous Document:  Longitudinal monocyte human leukocyte antigen-DR expression is a prognostic marker in critically ill...
Next Document:  Carbon monoxide produced by intrasinusoidally located haem-oxygenase-1 regulates the vascular tone i...