The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy.
- Author:
Jeong Han KIM
1
;
Sung Hyun AHN
;
Soon Young KO
;
Won Hyeok CHOE
;
Kyun Hwan KIM
;
So Young KWON
Author Information
- Publication Type:Original Article
- Keywords: Chronic Hepatitis B; Entecavir; Adefovir; Lamivudine; Tenofovir; Resistance
- MeSH: Adenine/*analogs & derivatives/therapeutic use; Adult; Aged; Antiviral Agents/*therapeutic use; DNA, Viral/analysis/metabolism; Drug Resistance, Viral; Drug Therapy, Combination; Female; Guanine/*analogs & derivatives/therapeutic use; Hepatitis B virus/genetics/isolation & purification; Hepatitis B, Chronic/*drug therapy/virology; Humans; Male; Middle Aged; Organophosphonates/*therapeutic use; Polymerase Chain Reaction; Republic of Korea; Retrospective Studies; Tenofovir/*therapeutic use; Treatment Outcome
- From:Clinical and Molecular Hepatology 2016;22(2):241-249
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Before tenofovir (TDF) become available in South Korea, combination therapy with entecavir (ETV) and adefovir (ADV) was the most potent regimen for chronic hepatitis B (CHB) patients who fail to respond to rescue therapy for drug resistance. We analyzed the efficacy of ETV-ADV combination therapy and investigated the clinical and clonal results of TDF-based rescue therapy in CHB patients refractory to this combination. METHODS: We retrospectively reviewed the medical records of CHB patients treated for up to 3 years with ETV-ADV combination therapy as a rescue therapy for drug resistance. In cases refractory to this combination, clinical and clonal analyses were performed for TDF-based rescue therapy. RESULTS: The analysis was performed on 48 patients. Twelve patients achieved a virological response (VR) within 3 years. A VR was subsequently achieved in nine of the ten patients without a VR who switched to TDF monotherapy. A VR was also achieved in six of the seven patients who switched to lamivudine-TDF combination therapy, and in two of the two patients who switched to ETV-TDF combination therapy. In an in vitro susceptibility test, viral replication was detected with TDF monotherapy but not with ETV-TDF combination therapy. CONCLUSIONS: The efficacy of ETV-ADV combination therapy was insufficient in CHB patients who were refractory to rescue therapy. A more potent regimen such as ETV-TDF combination therapy may be considered in such refractory cases.
