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Prediction of virologic response to tenofovir mono-rescue therapy for multidrug resistant chronic hepatitis B

Authors
 Sangheun Lee  ;  Jun Yong Park  ;  Do Young Kim  ;  Beom Kyung Kim  ;  Seung Up Kim  ;  Kijun Song  ;  Hye Jin Ku  ;  Kwang-Hyub Han  ;  Sang Hoon Ahn 
Citation
 Journal of Medical Virology, Vol.88(6) : 1027-1034, 2016 
Journal Title
 Journal of Medical Virology 
ISSN
 0146-6615 
Issue Date
2016
MeSH
Adult ; Antiviral Agents/adverse effects ; Antiviral Agents/therapeutic use* ; DNA, Viral/blood* ; Drug Resistance, Multiple, Viral ; Female ; Hepatitis B virus/drug effects* ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/drug therapy* ; Hepatitis B, Chronic/virology ; Humans ; Male ; Middle Aged ; Tenofovir/adverse effects ; Tenofovir/therapeutic use* ; Treatment Outcome ; Viral Load/drug effects
Keywords
chronic hepatitis B ; multidrug resistance ; tenofovir ; virologic response
Abstract
Most guidelines suggest combination therapy including nucleoside and nucleotide analogues for the treatment of chronic hepatitis B (CHB) with multidrug resistance (MD-R). However, long-term combination treatment can evoke high costs and safety problems. Therefore, we investigated the efficacy of tenofovir disoproxil fumarate (TDF) mono-rescue therapy for viral suppression in patients with CHB exhibiting MD-R. We reviewed patients with CHB exhibiting antiviral drug resistance treated by TDF mono-rescue therapy from December 2012 to June 2014. The patients were categorized into three groups: lamivudine-resistance (LAM-R) group (n = 290), and LAM-R + adefovir-resistance (ADV-R) group (n = 43), and LAM-R + entecavir-resistance (ETV-R) group (n = 113). We compared the virologic response rate according to the multiplicity of resistance and investigated the predictive factors of a virologic response. For a median of 15 months (range, 6-24 months) of TDF mono-rescue therapy, the cumulative virologic response rates were 82.8, 81.4, and 84.1% in the LAM-R, LAM-R + ADV-R, and LAM-R + ETV-R groups, respectively (P = 0.239). Multivariate analysis revealed that multiplicity of resistance did not influence the achievement of a virologic response (P = 0.218). However, the baseline HBV DNA level significantly influenced the achievement of a virologic response for the treatment of CHB with MD-R (P < 0.001). TDF mono-rescue therapy is an appropriate treatment for CHB with MD-R, and the baseline HBV DNA level is a significant predictive factor for a virologic response. These factors should be considered before treating CHB with MD-R.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jmv.24427/abstract
DOI
10.1002/jmv.24427
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Song, Ki Jun(송기준) ORCID logo https://orcid.org/0000-0003-2505-4112
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146628
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