Impact of prior lamivudine use on the antiviral efficacy and development of resistance to entecavir in chronic hepatitis B patients.
10.3350/cmh.2015.21.2.131
- Author:
Joo An HWANG
1
;
Kee Bum KIM
;
Min Jae YANG
;
Sun Gyo LIM
;
Jae Chul HWANG
;
Jae Youn CHEONG
;
Sung Won CHO
;
Soon Sun KIM
Author Information
1. Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea. cocorico99@gmail.com
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Chronic hepatitis B;
Entecavir;
Lamivudine;
Resistance
- MeSH:
Adolescent;
Adult;
Aged;
Antiviral Agents/*therapeutic use;
DNA, Viral/blood;
*Drug Resistance, Viral/genetics;
Female;
Genotype;
Guanine/*analogs & derivatives/therapeutic use;
Hepatitis B virus/genetics;
Hepatitis B, Chronic/*drug therapy/virology;
Humans;
Lamivudine/*therapeutic use;
Male;
Middle Aged;
Remission Induction;
Retrospective Studies;
Young Adult
- From:Clinical and Molecular Hepatology
2015;21(2):131-140
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: To determine the efficacies of entecavir (ETV) in nucleos(t)ide analogue (NA)-naive chronic hepatitis B (CHB) patients and in those with prior lamivudine (LAM) use who did not develop resistance. METHODS: We retrospectively enrolled 337 patients with CHB who were treated with ETV (0.5 mg daily) for at least 30 months. The study included 270 (80.1%) NA-naive patients and 67 (19.9%) LAM-use patients. Ten of the LAM-use patients were refractory to LAM therapy without developing resistance. RESULTS: Genotypic resistance to ETV developed more frequently in the LAM-use group (13.1%) than in the NA-naive group (2.6%) at 60 months (P=0.009). In subgroup analysis, after excluding the 10 patients who were refractory to LAM therapy, the cumulative probability of ETV resistance did not differ significantly between the two groups (P=0.149). Prior LAM refractoriness and a higher hepatitis B virus DNA level at month 12 were independent predictive factors for the development of ETV resistance. CONCLUSIONS: ETV resistance developed more frequently in LAM-use patients with CHB. However, prior LAM use without refractoriness did not affect the development of ETV resistance. The serum hepatitis B virus DNA level at month 12 was a major predictor for the development of ETV resistance.
