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Partial Virological Response to Adefovir Add-On Lamivudine Rescue Therapy in Patients with Lamivudine-Resistant Chronic Hepatitis B

 Chon Y.E.  ;  Park J.Y.  ;  Ahn S.H.  ;  Kim D.Y.  ;  Han K.-H.  ;  Chon C.Y.  ;  Choi A.  ;  Kim S.U 
 DIGESTION, Vol.87(3) : 196-203, 2013 
Journal Title
Issue Date
Adenine/administration & dosage ; Adenine/analogs & derivatives* ; Adult ; Area Under Curve ; DNA, Viral/blood* ; Drug Resistance, Viral* ; Drug Therapy, Combination ; Female ; Hepatitis B, Chronic/blood ; Hepatitis B, Chronic/drug therapy* ; Hepatitis B, Chronic/virology ; Humans ; Lamivudine/administration & dosage* ; Male ; Middle Aged ; Organophosphonates/administration & dosage* ; ROC Curve ; Reverse Transcriptase Inhibitors/administration & dosage* ; Treatment Outcome
Add-on therapy ; Adefovir ; Chronic hepatitis B ; Hepatitis B virus DNA ; Hepatitis B virus ; Lamivudine ; Nucleos(t)ide analogue ; Partial virological response ; Virological response
BACKGROUND/AIMS: In patients with lamivudine (LAM)-resistant chronic hepatitis B (CHB) receiving adefovir (ADV) add-on LAM therapy, insufficient viral suppression or the appearance of additional ADV resistance has remained unresolved. This study determined the partial virological response (PVR) criteria to predict a virological response (VR) at week 96 in these patients. METHODS: 96 patients with LAM-resistant CHB (ADV add-on LAM therapy >2 years) were analyzed. For predicting VR at week 96, the area under the receiver operating characteristic curve values at different time points were compared to establish the optimal time point, and the maximal Youden index was calculated to determine the optimal cut-off hepatitis B virus (HBV) DNA level. RESULTS: 50 (52.1%) patients achieved VR at 2 years after ADV add-on LAM therapy. The optimal PVR criteria were determined to be HBV DNA 500 IU/ml at week 48. 44 (45.8%) patients who met optimal PVR criteria showed a significantly higher risk for detectable HBV DNA levels at week 96 than those with a favorable VR (HBV DNA <500 IU/ml) at week 48. CONCLUSIONS: This study suggested optimal PVR criteria in patients with LAM-resistant CHB receiving ADV add-on LAM therapy. Modification of the antiviral agent regimen should be considered if the serum HBV DNA level exceeds 500 IU/ml at week 48.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
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
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Jeon, Young Eun(전영은)
Chon, Chae Yoon(전재윤)
Choi, A Ra(최아라)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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