Adefovir and Lamivudine Combination Therapy in Patients with Entecavir-Resistant Chronic Hepatitis B: Antiviral Responses and Evolution of Mutations
- Yim, Hyung Joon; Lee, Hyun Jung; Suh, Sang Jun; Seo, Yeon Seok; Kim, Chang Wook; Lee, Chang Don; Park, Sang Hoon; Lee, Myung Seok; Park, Choong Kee; Chae, Hee Bok; Kim, Moon Young; Baik, Soon Koo; Kim, Yun Soo; Kim, Ju Hyun; Il Lee, Jung; Hong, Sun Pyo; Um, Soon Ho
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- Adefovir; Chronic hepatitis B; Entecavir; Lamivudine; Resistance
- INTERVIROLOGY, v.57, no.5, pp.239 - 247
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- Objective: This study was designed to prospectively evaluate the antiviral responses and evolution of resistance mutations during adefovir (ADV) plus lannivudine (LMV) therapy in patients with entecavir (ETV)-resistant hepatitis B virus (HBV) infection. Methods: Twenty chronic hepatitis B (CHB) patients who had been receiving ETV for more than 6 months and developed virologic breakthrough due to ETV resistance were consecutively enrolled. Results: Patients received ADV plus LMV therapy for 12 months. The baseline mean serum HBV DNA level was 5.59 +/- 1.28 log(10) IU/ml. The rtT184L/1/A/F (50%), rtS202G (25%) and mixed ETV-resistant mutations (25%) were detected at enrollment. The mean reduction in serum HBV DNA levels from baseline to 12 months was -2.3 +/- 1.06 log(10) IU/ml (p < 0.001). Seventeen patients were followed up for the full 12 months, and complete virologic response (HBV DNA <20 IU/ml) was observed in 4 patients (23.5%). Among the remaining 13 patients who still had detectable HBV DNA, 7 patients showed disappearance of ETV-resistant mutations or reduction of the proportion of ETV-resistant mutants. An ADV- and LMV-resistant mutant (rtA181T) emerged in 2 patients (11.7%). Conclusions: ADV plus LMV combination therapy suppresses ETV-resistant mutants in the viral population and significantly reduces serum HBV DNA levels in ETV-resistant CHB patients. (C) 2014 S. Karger AG, Basel
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- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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