Adefovir plus lamivudine are more effective than adefovir alone in lamivudine-resistant HBeAg- chronic hepatitis B patients: a 4-year study.
Τίτλος | Adefovir plus lamivudine are more effective than adefovir alone in lamivudine-resistant HBeAg- chronic hepatitis B patients: a 4-year study. |
Publication Type | Journal Article |
Year of Publication | 2010 |
Authors | Vassiliadis, T. G., Giouleme O., Koumerkeridis G., Koumaras H., Tziomalos K., Patsiaoura K., Grammatikos N., Mpoumponaris A., Gkisakis D., Theodoropoulos K., Panderi A., Katsinelos P., & Eugenidis N. |
Journal | J Gastroenterol Hepatol |
Volume | 25 |
Issue | 1 |
Pagination | 54-60 |
Date Published | 2010 Jan |
ISSN | 1440-1746 |
Λέξεις κλειδιά | Adenine, Adult, Aged, Alanine Transaminase, Antiviral Agents, Biological Markers, DNA, Viral, Drug Resistance, Multiple, Viral, Drug Therapy, Combination, Female, Genotype, Hepatitis B, Hepatitis B e Antigens, Hepatitis B, Chronic, Humans, Lamivudine, Male, Middle Aged, Organophosphonates, Time Factors, Treatment Outcome, Viral Load, Young Adult |
Abstract | BACKGROUND AND AIM: Adefovir dipivoxil (ADV) is effective in lamivudine (LAM)-resistant hepatitis B e antigen-negative (HBeAg(-)) chronic hepatitis B (CHB). However, it is unclear whether LAM treatment should be continued in these patients. We aimed to compare the long-term efficacy of adding ADV to ongoing LAM treatment versus switching to ADV monotherapy in LAM-resistant HBeAg(-) CHB.METHODS: Sixty LAM-resistant patients with HBeAg(-) CHB were randomly assigned (3:1) to combination therapy (10 mg ADV once daily plus ongoing LAM at 100 mg once daily [n = 45]) or 10 mg ADV monotherapy once daily (n = 15). Virological and biochemical responses were defined as hepatitis B virus (HBV)-DNA <400 copies/mL and as normalization of alanine aminotransferase levels, respectively.RESULTS: The median follow-up time was 53 months (range 20-60 months). A virological response was observed in 38/45 (84.4%) and 11/15 (73.3%) patients in the ADV/LAM and ADV monotherapy groups, respectively (P = 0.56). Biochemical response rates were higher in the ADV/LAM group than in the ADV monotherapy group (90.9% vs 57.1%, respectively; P = 0.01). In the ADV/LAM group, serum HBV-DNA remained undetectable in all patients who achieved a virological response (n = 38). In the ADV monotherapy group, virological breakthrough occurred in four of the 11 patients who achieved a virological response (36.4%; P < 0.001 vs the ADV/LAM group, log-rank test). In addition, two patients in each group who did not achieve a virological response eventually developed ADV resistance.CONCLUSIONS: Adding ADV to LAM is more effective than switching to ADV monotherapy in LAM-resistant patients with HBeAg(-) CHB. |
DOI | 10.1111/j.1440-1746.2009.05952.x |
Alternate Journal | J. Gastroenterol. Hepatol. |
PubMed ID | 19780875 |