Prime

Type your tag names separated by a space and hit enter

Virologic responses to add-on adefovir dipivoxil treatment versus entecavir monotherapy in children with lamivudine-resistant chronic hepatitis B.

Abstract

PURPOSE

The aim of the study was to compare the virologic response to adefovir (ADV) add-on therapy with switching to entecavir (ETV) monotherapy in children and adolescents with chronic hepatitis B (CHB) who have developed lamivudine (LAM) resistance during LAM treatment.

METHODS

Twenty-seven consecutive patients with CHB who had developed LAM resistance during LAM treatment were included. Of these 27 patients, 8 patients were treated with the addition of ADV to ongoing LAM and 8 patients were treated by switching to ETV monotherapy and each of these 16 patients were compared with the 11 patients who were treated by switching to ADV alone, as a historical control. Therapeutic responses to treatment were evaluated at 12, 24, 36, and 48 weeks from the initiation of therapy by measuring the decrement of hepatitis B virus (HBV)-DNA titers.

RESULTS

The therapeutic period for HBV-DNA titer decrement (>2  log(10) IU/mL) was significantly shorter in both the LAM+ADV group and the ETV group than in the ADV group (P = 0.008); however, there was no significant difference between the LAM+ADV group and the ETV group. The rate of virologic response, defined as decrement in HBV-DNA titer to undetectable levels at 24 weeks, was significantly higher in both the LAM+ADV group and the ETV group than in the ADV group (P = 0.029).

CONCLUSIONS

Both the LAM+ADV combination therapy and ETV monotherapy exhibited significantly more effective virologic responses compared to the ADV monotherapy in children and adolescents with LAM-resistant CHB, although there was no significant difference between the LAM+ADV group and the ETV group.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.

    , , , ,

    Source

    MeSH

    Adenine
    Adolescent
    Antiviral Agents
    Child
    Child, Preschool
    DNA, Viral
    Drug Resistance, Viral
    Drug Therapy, Combination
    Female
    Guanine
    Hepatitis B virus
    Hepatitis B, Chronic
    Humans
    Lamivudine
    Male
    Organophosphonates
    Treatment Outcome
    Viral Load

    Pub Type(s)

    Comparative Study
    Controlled Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22688509

    Citation

    TY - JOUR T1 - Virologic responses to add-on adefovir dipivoxil treatment versus entecavir monotherapy in children with lamivudine-resistant chronic hepatitis B. AU - Chu,Miae, AU - Cho,Seung Man, AU - Choe,Byung-Ho, AU - Cho,Min Hyun, AU - Kwon,Soonhak, AU - Lee,Won Kee, PY - 2012/6/13/entrez PY - 2012/6/13/pubmed PY - 2013/5/1/medline SP - 648 EP - 52 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 55 IS - 6 N2 - PURPOSE: The aim of the study was to compare the virologic response to adefovir (ADV) add-on therapy with switching to entecavir (ETV) monotherapy in children and adolescents with chronic hepatitis B (CHB) who have developed lamivudine (LAM) resistance during LAM treatment. METHODS: Twenty-seven consecutive patients with CHB who had developed LAM resistance during LAM treatment were included. Of these 27 patients, 8 patients were treated with the addition of ADV to ongoing LAM and 8 patients were treated by switching to ETV monotherapy and each of these 16 patients were compared with the 11 patients who were treated by switching to ADV alone, as a historical control. Therapeutic responses to treatment were evaluated at 12, 24, 36, and 48 weeks from the initiation of therapy by measuring the decrement of hepatitis B virus (HBV)-DNA titers. RESULTS: The therapeutic period for HBV-DNA titer decrement (>2  log(10) IU/mL) was significantly shorter in both the LAM+ADV group and the ETV group than in the ADV group (P = 0.008); however, there was no significant difference between the LAM+ADV group and the ETV group. The rate of virologic response, defined as decrement in HBV-DNA titer to undetectable levels at 24 weeks, was significantly higher in both the LAM+ADV group and the ETV group than in the ADV group (P = 0.029). CONCLUSIONS: Both the LAM+ADV combination therapy and ETV monotherapy exhibited significantly more effective virologic responses compared to the ADV monotherapy in children and adolescents with LAM-resistant CHB, although there was no significant difference between the LAM+ADV group and the ETV group. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/22688509/Virologic_responses_to_add_on_adefovir_dipivoxil_treatment_versus_entecavir_monotherapy_in_children_with_lamivudine_resistant_chronic_hepatitis_B_ L2 - http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0277-2116&volume=55&issue=6&spage=648 ER -