High efficacy of adefovir and entecavir combination therapy in patients with nucleoside-refractory hepatitis B / 대한간학회지
The Korean Journal of Hepatology
;
: 75-83, 2012.
Article
in English
| WPRIM
| ID: wpr-102517
ABSTRACT
BACKGROUND/AIMS:
Newly developed and potent antiviral agents suffer from the problem of drug resistance. Multidrug resistance is a major impediment in the treatment of patients with chronic hepatitis B (CHB). In line with American Association for the Study of Liver Diseases guidelines, adefovir dipivoxil (ADV) add-on therapy is recommended in the case of lamivudine resistance, while tenofovir disoproxil fumarate (TDF) is recommended for ADV or entecavir (ETV) resistance. TDF is currently not available in Korea. ADV+ETV combination therapy may be a viable alternative to TDF in patients with either ADV or ETV resistance. However, the efficacy of ADV+ETV combination therapy in patients with CHB and multidrug resistance is unclear. This study investigated the efficacy of ADV+ETV combination therapy in patients with multidrug resistance.METHODS:
Twenty-five patients were enrolled and were administered ADV+ETV combination therapy for at least 6 months. Blood was drawn at baseline and at 3, 6, 9, and 12 months after commencing treatment, and the following blood parameters were analyzed alanine transaminase, hepatitis B e-antigen (HBeAg), anti-hepatitis B e-antigen, and hepatitis B virus (HBV) DNA levels. The initial virological response (IVR) was defined as an HBV DNA level of or =5.0 log) dropped from 76% at baseline to only 5% after 6 months of treatment. The biochemical response rate during the first 6 months was 71%. HBeAg was lost in 2 patients (10%).CONCLUSIONS:
ADV+ETV combination therapy induced a good IVR in CHB patients who were refractory to more than 2 antiviral agents. This regimen may be a good alternative to TDF in Korea, where that drug is not available.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Antiviral Agents
/
Phosphorous Acids
/
DNA, Viral
/
Adenine
/
Hepatitis B, Chronic
/
Drug Resistance, Multiple, Viral
/
Alanine Transaminase
/
Drug Therapy, Combination
/
Genotype
/
Guanine
Type of study:
Practice guideline
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
The Korean Journal of Hepatology
Year:
2012
Type:
Article
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