Virologic response to adefovir dipivoxil monotherapy is not durable in HBeAg-positive, lamivudine-resistant chronic hepatitis B patients.
10.3350/kjhep.2009.15.1.52
- Author:
Hyun Wook JUNG
1
;
Moon Seok CHOI
;
Kap Hyun KIM
;
Sung Hyun PARK
;
Kwak Keum YEON
;
Joon Hyoek LEE
;
Kwang Cheol KOH
;
Seung Woon PAIK
;
Byung Chul YOO
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drmschoi@gmail.com
- Publication Type:Original Article ; English Abstract
- Keywords:
Adefovir dipivoxil;
Lamivudine;
Drug Resistance, Viral;
Durability
- MeSH:
Adenine/*analogs & derivatives/therapeutic use;
Adult;
Aged;
Antiviral Agents/*therapeutic use;
DNA, Viral/analysis;
Drug Resistance, Viral;
Female;
Hepatitis B e Antigens/*blood;
Hepatitis B, Chronic/*drug therapy;
Humans;
Lamivudine/*therapeutic use;
Male;
Middle Aged;
Phosphonic Acids/*therapeutic use;
Recurrence;
Retrospective Studies;
Risk Factors
- From:The Korean Journal of Hepatology
2009;15(1):52-58
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUNDS/AIMS: It has been shown that adefovir dipivoxil is an effective antiviral agent in the treatment of chronic hepatitis B (CHB), not only in wild-type hepatitis B virus (HBV) infection, but also in lamivudine-resistant (LAMV-R) cases. However, little is known about the durability of the virologic response to adefovir in LAMV-R CHB patients. METHODS: Fifteen HBV e-antigen (HBeAg)-positive, LAMV-R CHB patients showed a virologic response to adefovir monotherapy. These patients received additional adefovir for at least a further 12 months. The virologic relapse rate after discontinuation of adefovir was evaluated. In addition, predictive factors associated with virologic relapse were investigated. RESULTS: The median level of serum HBV DNA before adefovir administration was 7,457,840 IU/mL (range 107,920-99,524,960 IU/mL). The median duration of adefovir treatment was 30 months (range 14-46 months). During a median follow-up period of 14 months after discontinuation of adefovir, the 1-, 2-, 3-, 6-, and 12-month cumulative relapse rates were 26.7%, 53.3%, 73.3%, 80%, and 80%, respectively. High pretreatment HBV DNA levels were found to be the only factor that was predictive of off-therapy relapse. CONCLUSIONS: Our data suggest that the adefovir-monotherapy-induced virologic response is not durable in most patients with LAMV-R HBeAg-positive CHB, especially in those with a high pretreatment HBV DNA level.
