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Lamivudine plus adefovir vs. entecavir in HBeAg-positive hepatitis B with sequential treatment failure of lamivudine and adefovir.

Authors
 Chang Young Son  ;  Han Jak Ryu  ;  Jung Min Lee  ;  Sang Hoon Ahn  ;  Do Young Kim  ;  Myoung Ha Lee  ;  Kwang Hyub Han  ;  Chae Yoon Chon  ;  Jun Yong Park 
Citation
 Liver International, Vol.32(7) : 1179-1185, 2012 
Journal Title
 Liver International 
ISSN
 1478-3223 
Issue Date
2012
Abstract
BACKGROUND AND AIMS: Few studies have adequately examined the efficacy of lamivudine plus adefovir (LAM+ADV) combination therapy vs. entecavir (ETV) monotherapy in HBeAg-positive hepatitis B patients who fail to respond to sequential treatment with LAM and ADV. We compared directly the efficacy of LAM+ADV vs. ETV in such patients and assessed prognostic factors associated with a virologic response at month 12. METHODS: In total, 72 HBeAg-positive patients who showed resistance (n = 33) or a suboptimal virologic response (n = 39) to ADV monotherapy with resistance to LAM therapy underwent rescue therapy (31 LAM+ADV and 41 ETV). All patients were followed for at least 12 months. RESULTS: Following 12 months of treatment, in the LAM+ADV and ETV groups, a virologic response was observed in 7/31 (22.6%) and 8/41 (19.5%; P = 0.777) patients; ALT normalization occurred in 11/13 (84.6%) and 16/18 (88.9%; P = 0.566); HBeAg seroconversion in 1/31 (2.3%) and 4/41 (9.8%; P = 0.341) and a virologic breakthrough in 3/31 (9.0%) and 5/41 (12.1%; P = 0.452) respectively. Independent prognostic factors associated with a virologic response were the baseline HBV-DNA level (OR = 0.37; 95% CI 0.17-0.80; P = 0.011) and the duration of prior ADV monotherapy (OR = 0.89; 95% CI 0.83-0.95; P = 0.044). CONCLUSIONS: Neither LAM+ADV nor ETV was adequately effective in patients with sequential LAM and ADV treatment failure. Thus, when chronic hepatitis B patients show resistance or suboptimal response to ADV monotherapy, early modification of treatment should be considered.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91415
DOI
10.1111/j.1478-3231.2012.02793.x
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김도영(Kim, Do Young)
류한작(Ryu, Han Jak)
박준용(Park, Jun Yong)
손창영(Son, Chang Young)
안상훈(Ahn, Sang Hoon)
이명하(Lee, Myoung Ha)
이중민(Lee, Jung Min)
전재윤(Chon, Chae Yoon)
한광협(Han, Kwang Hyup)
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Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2012.02793.x/abstract
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