Virologic Response at 12 Months of Treatment Predicts Sustained Antiviral Efficacy in Patients with Adefovir-Treated Lamivudine-Resistant Chronic Hepatitis B
- Jung, Young Kul; Yeon, Jong Eun; Han, Woo Sik; Kim, Ji Hoon; Kim, Jeong Han; Park, Jong-Jae; Kim, Jae Seon; Bak, Young-Tae; Yoo, Wangdon; Hong, Sun Pyo; Kim, Soo-Ok; Kwon, So Young; Byun, Kwan Soo; Lee, Chang Hong
- Issue Date
- 거트앤리버 발행위원회
- Adefovir dipivoxil; Drug resistance; Virologic response
- Gut and Liver, v.4, no.2, pp.212 - 218
- Journal Title
- Gut and Liver
- Start Page
- End Page
- Background/Aims: The aim of our study was to define the potential role of virologic response at 12 months of treatment (VR12) in predicting subsequent virologic and clinical outcomes in adefovir (ADV)-treated lamivudine-resistant chronic hepatitis B.
Methods: Two hundred and four patients with lamivudine-resistant chronic hepatitis B virus (HBV) treated with ADV monotherapy were included. Serum HBV DNA was quantified by real-time polymerase chain reactions. VR12 was defined as a HBV DNA level of less than 4 log(10) copies/mL after 12 months of ADV treatment.
Results: VR12 was observed in 110 of the 204 patients (54%). The mean HBV DNA reductions from baseline after 12 months of ADV treatment were 3.8 and 1.9 log(10) copies/mL in patients with and without VR12, respectively (p<0.001). The hepatitis B "e" antigen (HBeAg) seroconversion rates in patients with and without VR12 were 32% and 14% at 12 months treatment, respectively (p=0.018), and 40% and 27% at 24 months of treatment (p=0.032). The genotypic mutation rates to ADV in patients with and without VR12 were 0% and 6% at 12 months of treatment, respectively (p=0.033), and 21% and 42% at 24 months (p=0.012). The rates of viral breakthrough in patients with and without VR12 were 0% and 7% at 12 months of treatment, respectively (p=0.072), and 9% and 25% at 24 months (p=0.006).
Conclusions: Patients without VR12 may need to switch to or add on other potent antiviral drugs in their medical regimens. (Gut Liver 2010;4:212-218)
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- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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