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Cited 3 time in webofscience Cited 2 time in scopus
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Management of Clevudine-Resistant Chronic Hepatitis B: A Multicenter Cohort Study

Authors
Cho, Eun YoungYim, Hyung JoonJung, Young KulSuh, Sang JunSeo, Yeon SeokKim, Ji HoonKim, Hong SooLee, Sae HwanAhn, Sang HoonLees, Jeong IlJeong, Sook-HyangKim, Jin-WookLee, Jin-WooKim, In HeeKim, Hyoung SuPark, Sang JongLee, Jeong MiHwang, Seong Gyu
Issue Date
Jan-2017
Publisher
EDITORIAL OFFICE GUT & LIVER
Keywords
Clevudine; Resistance; Hepatitis B; chronic; Therapy
Citation
GUT AND LIVER, v.11, no.1, pp.129 - 135
Indexed
SCIE
SCOPUS
KCI
Journal Title
GUT AND LIVER
Volume
11
Number
1
Start Page
129
End Page
135
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/5415
DOI
10.5009/gn115597
ISSN
1976-2283
Abstract
Background/Aims: Data are lacking regarding the management of chronic hepatitis B (CHB) with resistance to clevudine (CLV). This study evaluated the efficacy of different rescue therapies for CLV-resistant CHB. Methods: Patients with CLV-resistant CHB were enrolled in the cohort, and all patients developed virologic breakthrough during CLV therapy and had confirmed-genotypic resistance to CLV (rtM2041 mutation) before enrollment. Results: Of the 107 patients, 12 received adefovir (ADV), 21 received a CLV plus ADV combination (CLV+ADV), 34 received a lamivudine plus ADV combination (LAM+ADV), and 40 received entecavir (ETV) therapy for 48 weeks. The CLV+ADV group had the lowest hepatitis B virus (HBV) DNA level (p<0.0001) and showed the greatest reduction of HBV DNA levels from baseline compared to all other groups (p=0.004) at week 48. HBV DNA was undetectable (<70 IU/mL) in 0%, 57.1%, 21.2%, and 27.5% (p=0.003) of the patients in each group, respectively, at week 48. At the end of the study, the mean alanine transaminase (ALT) level, rate of ALT normalization, and rate of hepatitis B envelope antigen loss or seroconversion did not differ between groups. Conclusions: CLV+ADV combination therapy in patients with CLV-resistant CHB more effectively suppresses HBV replication than ETV, ADV, or LAM+ADV therapy.
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Jung, Young Kul
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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