Document Detail


Adefovir dipivoxil monotherapy and combination therapy with lamivudine for the treatment of chronic hepatitis B in an Asian population.
MedLine Citation:
PMID:  17503746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine differences in Chinese patients treated with adefovir (ADV) monotherapy or ADV in combination with lamivudine (3TC) after development of resistance to 3TC, with respect to biochemical improvement, HBV DNA suppression and development of subsequent ADV resistance.
METHODS: All hepatitis B patients with 3TC resistance treated with ADV for 3 months or more at our centre were included, and monitored 3-6 monthly for biochemical and virological response, and development of ADV resistance.
RESULTS: A total of 56 patients were included, 50% switched to ADV monotherapy and 50% received combination 3TC/ADV therapy. Median follow-up was 15.5 months. Normalization of alanine aminotransferase (ALT) occurred in 25 (89%) patients in the ADV group compared with 24 (86%) in the 3TC/ADV group (P = 0.686). Virological response (VR) was achieved in seven (35%) patients in the ADV group at 12 months compared with five (28%) in the 3TC/ADV group (P = 0.637). By 24 months, seven (64%) patients in the ADV group achieved VR compared with two (40%) in the 3TC/ADV group (P = 0.377). Cumulative probability of developing genotypic ADV resistance in the ADV group at 24 months was 18% compared with 7% in the 3TC/ADV group (P = 0.94).
CONCLUSION: There was no obvious improvement in ALT normalization and virological suppression or reduction in the development of ADV-resistant mutations with 3TC/ADV therapy compared with ADV monotherapy. Further studies with longer follow-ups are required to determine whether combination 3TC/ADV therapy will reduce the emergence of ADV resistance compared with ADV monotherapy.
Authors:
James Fung; Ching-Lung Lai; John Chi-hang Yuen; Danny Ka-Ho Wong; Yasuhito Tanaka; Masashi Mizokami; Man-Fung Yuen
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Antiviral therapy     Volume:  12     ISSN:  1359-6535     ISO Abbreviation:  Antivir. Ther. (Lond.)     Publication Date:  2007  
Date Detail:
Created Date:  2007-05-16     Completed Date:  2007-06-07     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  9815705     Medline TA:  Antivir Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  41-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
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MeSH Terms
Descriptor/Qualifier:
Adenine / analogs & derivatives*,  therapeutic use
Adult
Aged
Alanine Transaminase / blood
Asian Continental Ancestry Group*
DNA, Viral / blood*
Drug Resistance, Multiple, Viral* / genetics
Drug Therapy, Combination
Female
Follow-Up Studies
Genotype
Hepatitis B virus / genetics*
Hepatitis B, Chronic / blood,  drug therapy*,  genetics
Hong Kong
Humans
Lamivudine / therapeutic use*
Male
Middle Aged
Organophosphonates / therapeutic use*
Reverse Transcriptase Inhibitors / therapeutic use*
Time Factors
Treatment Outcome
Viral Load
Chemical
Reg. No./Substance:
0/DNA, Viral; 0/Organophosphonates; 0/Reverse Transcriptase Inhibitors; 134678-17-4/Lamivudine; 73-24-5/Adenine; EC 2.6.1.2/Alanine Transaminase; U6Q8Z01514/adefovir dipivoxil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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