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Maintaining remission in lamivudine-resistant patients with a virological response to adefovir add-on lamivudine after stopping lamivudine therapy.

Authors
 Mi Na Kim  ;  Chun Kyon Lee  ;  Sang Hoon Ahn  ;  Sangheun Lee  ;  Seung Up Kim  ;  Do Young Kim  ;  Hyon Suk Kim  ;  Kwang Hyub Han  ;  Chae Yoon Chon  ;  Jun Yong Park 
Citation
 Liver International, Vol.34(10) : 1543-1549, 2014 
Journal Title
 Liver International 
ISSN
 1478-3223 
Issue Date
2014
Abstract
BACKGROUND & AIMS: We examined the durability of the virological response after discontinuing lamivudine (LVD) in chronic hepatitis B (CHB) patients with LVD-resistant hepatitis B virus (HBV), who responded to LVD plus adefovir (ADV) combination therapy, and the outcome of switching to ADV monotherapy compared to maintaining combination therapy. METHODS: This study enrolled 72 patients with undetectable viral loads (≤12 IU/ml) and normal alanine aminotransferase levels after ADV add-on therapy for at least 6 months in LVD-resistant CHB patients. The enrolled patients were randomly assigned to continue with LVD-ADV combination therapy or switch to ADV monotherapy (n = 36 per group). Virological rebound was defined as HBV DNA detection at more than 12 IU/ml by quantitative polymerase chain reaction determined on two consecutive measurements. RESULTS: During 96 weeks of follow-up, 100% (36/36) of the patients in the LVD-ADV combination maintained group had persistently undetectable HBV DNA, compared with 94.4% (34/36) patients in the ADV monotherapy switched group. These two patients had undetectable HBV DNA after switching back to LVD-ADV combination therapy. There were no significant differences in the HBsAg levels between the two treatment groups during the 96-week follow-up period. CONCLUSIONS: In our study, switching to ADV monotherapy resulted in sustained HBV DNA suppression in 94.4% of the patients for 96 weeks. Prior complete viral suppression with LVD-ADV combination therapy conferred a significant advantage in patients who switched to ADV monotherapy. LVD may be discontinued in patients who show a complete virological response to LVD-ADV combination therapy for at least 6 months.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/liv.12437/abstract
DOI
10.1111/liv.12437
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
김도영(Kim, Do Young)
김미나(Kim, Mi Na)
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
김현숙(Kim, Hyon Suk) ORCID logo https://orcid.org/0000-0001-5662-7740
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
이상헌(Lee, Sang Heun)
전재윤(Chon, Chae Yoon)
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138699
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