Virologic Response at 12 Months of Treatment Predicts Sustained Antiviral Efficacy in Patients with Adefovir-Treated Lamivudine-Resistant Chronic Hepatitis B.
- Author:
Young Kul JUNG
1
;
Jong Eun YEON
;
Woo Sik HAN
;
Ji Hoon KIM
;
Jeong Han KIM
;
Jong Jae PARK
;
Jae Seon KIM
;
Young Tae BAK
;
Wangdon YOO
;
Sun Pyo HONG
;
Soo Ok KIM
;
So Young KWON
;
Kwan Soo BYUN
;
Chang Hong LEE
Author Information
1. Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. je_yeon@hotmail.com
- Publication Type:Original Article
- Keywords:
Adefovir dipivoxil;
Drug resistance;
Virologic response
- MeSH:
Adenine;
Antiviral Agents;
DNA;
Drug Resistance;
Hepatitis B;
Hepatitis B, Chronic;
Hepatitis, Chronic;
Humans;
Mutation Rate;
Organophosphonates;
Polymerase Chain Reaction;
Viruses
- From:Gut and Liver
2010;4(2):212-218
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The aim of our study was to define the potential role of virologic response at 12 months of treatment (VR12) in predicting subsequent virologic and clinical outcomes in adefovir (ADV)-treated lamivudine-resistant chronic hepatitis B. METHODS: Two hundred and four patients with lamivudine-resistant chronic hepatitis B virus (HBV) treated with ADV monotherapy were included. Serum HBV DNA was quantified by real-time polymerase chain reactions. VR12 was defined as a HBV DNA level of less than 4 log10 copies/mL after 12 months of ADV treatment. RESULTS: VR12 was observed in 110 of the 204 patients (54%). The mean HBV DNA reductions from baseline after 12 months of ADV treatment were 3.8 and 1.9 log10 copies/mL in patients with and without VR12, respectively (p<0.001). The hepatitis B "e" antigen (HBeAg) seroconversion rates in patients with and without VR12 were 32% and 14% at 12 months treatment, respectively (p=0.018), and 40% and 27% at 24 months of treatment (p=0.032). The genotypic mutation rates to ADV in patients with and without VR12 were 0% and 6% at 12 months of treatment, respectively (p=0.033), and 21% and 42% at 24 months (p=0.012). The rates of viral breakthrough in patients with and without VR12 were 0% and 7% at 12 months of treatment, respectively (p=0.072), and 9% and 25% at 24 months (p=0.006). CONCLUSIONS: Patients without VR12 may need to switch to or add on other potent antiviral drugs in their medical regimens.
