A study on the treatment of chronic hepatitis B with YMDD mutation.
- Author:
Yuan-Wang QIU
1
;
Xiang-Hu JIANG
;
Li-Hua HUANG
;
Tai-Hong HU
;
Hong DING
;
Yue-Ming JIANG
;
Ya-Xin DAI
;
Min ZHOU
Author Information
- Publication Type:Journal Article
- MeSH: Adenine; administration & dosage; analogs & derivatives; therapeutic use; Adult; Alanine Transaminase; blood; Antiviral Agents; administration & dosage; therapeutic use; DNA, Viral; blood; Drug Resistance, Viral; Drug Therapy, Combination; methods; Female; Follow-Up Studies; Guanine; administration & dosage; analogs & derivatives; therapeutic use; Hepatitis B e Antigens; blood; Hepatitis B virus; drug effects; genetics; Hepatitis B, Chronic; drug therapy; virology; Humans; Lamivudine; administration & dosage; therapeutic use; Male; Middle Aged; Mutation; Organophosphonates; administration & dosage; therapeutic use; Reverse Transcriptase Inhibitors; administration & dosage; therapeutic use; Young Adult
- From: Chinese Journal of Hepatology 2009;17(3):171-174
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo explore the strategy for the treatment of chronic hepatitis B with YMDD mutation.
METHODSA total of 120 chronic hepatitis B patients with YMDD mutation were randomly assigned into four groups. In group A, patients received adefovir dipivoxil for 48 weeks. In group B, patients received adefovir dipivoxil in combination with lamivudine during the first 12 weeks and adefovir dipivoxil only for the following 36 weeks. In group C, patients received adefovir dipivoxil in combination with lamivudine for 48 weeks. In group D, patients received entecavir for 48 weeks.
RESULTSThe rate of rebound of alanine aminotransferase (ALT) was 30.0% (9/30), 10.0% (3/30), 6.7% (2/30), 10.0% (3/30) (P < 0.05) during the first 12 weeks, and one patient with severe hepatitis was found in group A. The positive rate of YMDD mutation was 17.9%, 0, 0, 0 at week 12. There was no significant difference in the level of ALT and the rate of HBeAg seroconversion after 48-week treatment (P > 0.05). At week 48, there was significant difference in the ALT normalization rate and undetectable HBV DNA rate between group C and group A, and also between group D and group A, and the rate of drug resistant genotype was 6.9%, 6.7%, 0, 0. Two patients had rtN236T mutation in group A, and one patient had rtN236T mutation and another one had rtA181V mutation in group B.
CONCLUSIONAdefovir dipivoxil in combination with lamivudine or entecavir are safe and effective therapies for chronic hepatitis B patients with YMDD mutation.
