Antiviral drug resistance and management after switching-to adefovir dipivoxil therapy in lamivudine-resistant chronic hepatitis B patients
- VernacularTitle:拉米夫定耐药慢性乙型肝炎患者改用阿德福韦酯单药治疗后发生耐药及处理
- Author:
Xianshan ZHOU
;
Mobin WAN
;
Ruiying ZHENG
- Publication Type:Journal Article
- Keywords:
Hepatitis B,chronic;
Lamivudine;
Adeforvir dipivoxil
- From:
Chinese Journal of Infectious Diseases
2008;26(10):604-608
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze clinical courses and rescue therapies of adefovir-resistant chronic hepatitis B patients who had lamivudine resistance before and then changed to take adefovir dipivoxil. Methods 15 patients resistant to lamivudine were retrospectively analyzed, who had virological breakthrough after adefovir dipivoxil monotherapy and were treated with rescue therapy.Adefovir-resistant mutations were detected by direct sequencing of the HBV polymerase gene. Results 15 patients with former lamivudine resistance were treated with adefovir dipivoxil monotherapy for a median of 16 months, and 14 patients were found adefovir-resistant mutations at rtA181T/V and(or) rtN236T, only 1 patient was found multi-mutations at rtM204I + rtL180M + rtA181T. Rescue therapies were given to all the 15 patients after drug resistance. Among the 7 patients treated with lamivudine in combination with adefovir for 3 months,whose HBV DNA levels decreased (2.2±0.6)lg copy/mL on average, 5 patients achieved HBV DNA undetectable after 6 months combinative therapy. The HBV DNA levels of the 3 patients treated with entecavir decreased 2.8～3.5 lg copy/mL within 6 months treatment. Conclusion These preliminary data suggest the combination of lamivudine and adeforvir dipivoxil may be an effective rescue therapy for adefovir-resistant patients who have former lamivudine resistance.
