Add-On Adefovir Is Superior to a Switch to Entecavir as Rescue Therapy for Lamivudine-Resistant Chronic Hepatitis B
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Goh Eun Chung Won Kim Kook Lae Lee Sang Youn Hwang Jeong-Hoon Lee Hwi Young Kim Yong Jin Jung Donghee Kim Ji Bong Jeong Byeong Gwa
- چاپ و سال / کشور: 2011
Description
Background/Aims Lamivudine (LAM) has been extensively used to treat hepatitis B, but high incidence of drug resistance has required rescue studies. We validated the optimum treatment strategy for LAM-resistant patients by means of a comparative study of add-on adefovir (ADV) and a switch to entecavir (ETV). Methods We assessed the virologic response in consecutive LAM-resistant patients who received add-on ADV or a switch to ETV. Results The mean reduction of serum hepatitis B virus (HBV) DNA levels was significantly less in the ETV group than in the add-on ADV group (-3.45 vs. -4.17; P = 0.047 at week 24 and -3.81 vs. -4.68 log10 IU/mL; P = 0.044 at week 48). Achievement of undetectable HBV DNA was significantly lower in the ETV group than in the add-on ADV group (P = 0.043). Multivariate analysis showed that add-on ADV, baseline HBV DNA levels, and initial virologic response were significant predictors of HBV DNA negativity (adjusted OR, 2.582; P = 0.008, 0.304; P = 0.001, and 5.928; P = 0.001). Virologic breakthrough was observed for 12 patients, in the ETV group only. Conclusions Add-on ADV was more effective and durable than ETV as rescue therapy. Therefore, add-on ADV might be the preferred strategy for LAM-resistant patients who need long-term antiviral treatment.
Dig Dis Sci (2011) 56:2130–2136 DOI 10.1007/s10620-010-1561-2 Received: 3 December 2010 / Accepted: 31 December 2010 / Published online: 21 January 2011
