Entecavir Resistance at rtS202, rtM250 May Cause Poor Viral Response to Tenofovir-based Rescue Therapy in Chronic Hepatitis B.
10.3904/kjm.2015.89.5.527
- Author:
Sung Eun KIM
1
;
Ji Won PARK
;
Hyoung Su KIM
;
Ki Tae SUK
;
Myoung Kuk JANG
;
Sang Hoon PARK
;
Myung Seok LEE
;
Dong Joon KIM
;
Choong Kee PARK
Author Information
1. Department of Internal Medicine, Hallym University, College of Medicine, Hallym University Medical Center, Anyang, Korea. mkjang@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Hepatitis B;
Partialvirologicalresponse;
Drug resistance;
Tenofovir
- MeSH:
Drug Resistance;
Genotype;
Hepatitis B;
Hepatitis B e Antigens;
Hepatitis B virus;
Hepatitis B, Chronic*;
Hepatitis, Chronic*;
Humans;
Lamivudine;
Multivariate Analysis;
Retrospective Studies;
Tenofovir
- From:Korean Journal of Medicine
2015;89(5):527-536
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Long-term use of nucleos(t)ide analogues (NA) may lead to genotypic and/or phenotypic resistance of the hepatitis B virus (HBV). We investigated the efficacy of tenofovir-based rescue therapy in chronic hepatitis B (CHB) patients with newly developed genotypic resistance to prior NAs or partial virologic response to sequential rescue therapies. METHODS: Fifty-four CHB patients were included retrospectively. The patients were treated with tenofovir alone or combined with lamivudine or entecavir. RESULTS: There were 26 forms of genotypic resistance at enrollment. The median amount of serum HBV-DNA was 18,438 IU/mL and 83% of samples were positive for hepatitis B e antigen (HBeAg). Serum HBV-DNA was undetectable in 50%, 61%, and 76% of the patients at 3, 6, and 12 months, respectively. In multivariate analysis, HBV-DNA < 20,000 IU/mL and negative HBeAg at baseline were independent predictors of negativity for serum HBV-DNA. Interestingly, the rtS202 mutation tended to be associated with an unfavorable response. Other clinical variables and viral resistance genotypes showed non-significant viral response. CONCLUSIONS: Lower serum HBV-DNA, negative HBeAg and lack of rtS202G mutations at baseline may predict a favorable response to tenofovir-based rescue therapies in CHB patients with newly developed genotypic resistance to prior NAs or a partial virologic response to sequential rescue therapies.
