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Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B

Other Titles
 다약제 내성 만성 B형 간염 환자에서 항바이러스 병합 치료의 효과 
Authors
 박미성 
Department
 Dept. of Internal Medicine (내과학교실) 
Issue Date
2013
Description
Dept. of Medicine/석사
Abstract
BACKGROUND: The incidence of multidrug-resistant (MDR)-chronic hepatitis B (CHB) during sequential lamivudine (LAM) and adefovir dipivoxil (ADV) treatment is increasing. We investigated the antiviral efficacies of various rescue regimens in patients who failed sequential LAM-ADV treatment.METHODS: A total of 48 patients (83.3% HBeAg-positive) who failed sequential LAM-ADV treatment were treated with one of the following regimens: entecavir (ETV) 1mg monotherapy (n=16), LAM+ADV combination therapy (n=20), or ETV(1mg)+ADV combination therapy (n=12). All patients had confirmed genotypic resistance to both LAM and ADV. Patients were evaluated every 12 weeks. RESULTS: There was no significant difference in the baseline characteristics and treatment duration among study groups. During treatments (median duration: 100 weeks), the decline of serum HBV DNA from baseline tended to be greatest in the ETV+ADV group at all-time points (week 48: -2.55 log10IU/ml, week 96: -4.27 log10IU/ml), but there was no statistical significance. The ETV+ADV group tended to have higher virologic response rates at 96 weeks compared to the ETV monotherapy or LAM+ADV groups (40.0% vs. 20.0% or 20.0%, p=0.656) and less virologic breakthrough was observed compared to the ETV monotherapy or LAM+ADV groups (8.3% vs. 37.5% or 30.0%, p=0.219), but there were no statistical significances. HBeAg loss occurred in one patient in the ETV+ADV group, two in the ETV monotherapy group, and none in the LAM+ADV group. Safety profiles were similar between each arm.CONCLUSIONS: ETV+ADV combination therapy tended to have a better antiviral efficacy compared to LAM+ADV or ETV monotherapy for MDR-CHB in Korea, where tenofovir is not yet available.
Full Text
https://ymlib.yonsei.ac.kr/catalog/search/book-detail/?cid=CAT000000139420
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 2. Thesis
Yonsei Authors
Park, Mi Sung(박미성)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/136423
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