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

Authors
 Mi Sung Park  ;  Beom Kyung Kim  ;  Kyung Sik Kim  ;  Ja Kyung Kim  ;  Seung Up Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Oidov Baartarkhuu  ;  Kwang Hyub Han  ;  Chae Yoon Chon  ;  Sang Hoon Ahn 
Citation
 Clinical and Molecular Hepatology, Vol.19(1) : 29-35, 2013 
Journal Title
 Clinical and Molecular Hepatology 
ISSN
 2287-2728 
Issue Date
2013
Abstract
Background/Aims: 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: Forty-eight patients (83.3% of whom were HBeAg-positive) who failed sequential LAM-ADV treatment were treated with one of the following regimens: entecavir (ETV) (1 mg) monotherapy (n=16), LAM+ADV combination therapy (n=20), or ETV (1 mg)+ADV combination therapy (n=12). All patients had confirmed genotypic resistance to both LAM and ADV and were evaluated every 12 weeks. Results: The baseline characteristics and treatment duration did not differ significantly among the study groups. During the treatment period (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 log10 IU/mL, week 96: -4.27 log10 IU/mL), but the difference was not statistically significant. The ETV+ADV group also 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 again, the differences were not statistically significant. HBeAg loss occurred in one patient in the ETV+ADV group, in two in the ETV monotherapy group, and in none of the LAM+ADV group. The safety profiles were similar in each arm. Conclusions: There was a nonsignificant tendency toward better antiviral efficacy with ETV+ADV combination therapy compared to LAM+ADV combination therapy and ETV monotherapy for MDR CHB in Korea, where tenofovir is not yet available.
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DOI
10.3350/cmh.2013.19.1.29
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김경식(Kim, Kyung Sik) ORCID logo https://orcid.org/0000-0001-9498-284X
김도영(Kim, Do Young)
김범경(Kim, Beom Kyung) ORCID logo https://orcid.org/0000-0002-5363-2496
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
김자경(Kim, Ja Kyung) ORCID logo https://orcid.org/0000-0001-5025-6846
박미성(Park, Mi Sung)
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
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/22282913/89229
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