Treatment of lamivudine-resistant chronic hepatitis B infection: a multicenter retrospective study
- Lee, Sun Jae; Yim, Hyung Joon; Hwang, Seong Gyu; Seo, Yeon Seok; Kim, Ji Hoon; Yoon, Eileen L.; Lee, Joong Min; Kim, Bo Hyun; Park, Sang Jong; Park, Young Min; Kim, Hong Soo; Lee, Se Hwan; Ahn, Sang Hoon; Lee, Jeong Il; Lee, Jin Woo; Kim, In Hee; Kim, Hyung Soo; Hong, Sun Pyo
- Issue Date
- INFORMA HEALTHCARE
- adefovir; antiviral resistance; chronic hepatitis B; combination drug therapy; entecavir; lamivudine; multicenter study
- SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, v.48, no.2, pp.196 - 204
- Journal Title
- SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
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- Objectives. To compare the efficacy of rescue therapies in lamivudine (LAM)-resistant chronic hepatitis B (CHB) infections including: (1) adefovir dipivoxil (ADV) monotherapy, (2) ADV plus LAM combination therapy and (3) entecavir (ETV) 1.0 mg monotherapy. Materials and methods. The authors designed a multicenter-retrospective study. Eight institutions participated in the study from Korea. Results. A total of 343 LAM-resistant CHB patients were enrolled. The proportion of patients with undetectable serum hepatitis B virus (HBV) DNA levels at month 24 after the initiation of rescue therapy was higher in the ADV plus LAM combination therapy group (39/64, 60.9%) than in the ADV monotherapy (50/126, 39.7%) and ETV 1.0 mg monotherapy (19/48, 39.6%) groups (p = 0.014). Mean serum HBV DNA levels at 24 months were 2.07 +/- 1.21 log(10) IU/ml in the ADV plus LAM combination therapy group, 2.74 +/- 1.74 log(10) IU/ml in the ADV monotherapy group and 3.08 +/- 1.97 log(10) IU/ml in the ETV 1.0 mg monotherapy group (p = 0.014). In multivariate analysis, a finding of undetectable serum HBV DNA level at 6 months and ADV plus LAM combination therapy (vs. ADV) was an independent factor for predicting undetectable serum HBV DNA at month 24 (odds ratio, 1.003; 95% confidence interval, 1.000-1.006; p = 0.026). Conclusions. ADV plus LAM combination therapy is more effective in reducing viral load than switching to ADV or ETV 1.0 mg in patients with LAM-resistant CHB.
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- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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