Long-Term Outcomes and Dynamics of Mutants Associated with Lamivudine-Adefovir Rescue Therapy in Patients with Lamivudine-Resistant Chronic Hepatitis B
Gut and Liver
;
: 103-108, 2015.
Article
in English
| WPRIM
| ID: wpr-61568
ABSTRACT
BACKGROUND/AIMS:
To investigate the association between the baseline profiles and dynamics of hepatitis B virus (HBV) DNA polymerase gene mutations and the long-term virological response of lamivudine (LAM)-adefovir (ADV) combination therapy in patients with LAM-resistant chronic hepatitis B.METHODS:
Seventy-five patients who received LAM-ADV combination therapy for more than 12 months were analyzed. Restriction fragment mass polymorphism assays were used to detect and monitor the dynamics of LAM- and ADV-resistant mutations.RESULTS:
The median duration of LAM-ADV combination therapy was 26 months (range, 12 to 58 months). The baseline mutation profiles, rtM204I (p=0.992), rtM204I/V (p=0.177), and rtL180M (p=0.051), were not correlated with the cumulative virological response, and the baseline HBV DNA level (p=0.032) was the only independent predictive factor for cumulative virological response. Tests for LAM- and ADV-resistant mutations were performed in 12 suboptimal responders in weeks 48 and 96. The population of rtM204 mutants persisted or increased in 8 of 12 patients, and rtA181T mutants newly emerged as a minor population in four patients until 96 weeks. Nevertheless, the viral loads progressively decreased during rescue therapy, and these dynamics did not correlate with virological response.CONCLUSIONS:
The baseline profile and dynamics of LAM-resistant mutations during LAM-ADV combination therapy are not associated with a virological response.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Antiviral Agents
/
Adenine
/
Hepatitis B virus
/
Treatment Outcome
/
Lamivudine
/
Viral Load
/
Hepatitis B, Chronic
/
Drug Resistance, Viral
/
DNA-Directed DNA Polymerase
/
Drug Therapy, Combination
Type of study:
Prognostic study
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Gut and Liver
Year:
2015
Type:
Article
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