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Comparison of re-treatment outcomes of lamivudine plus adefovir or entecavir in chronic hepatitis B patients with viral relapse after cessation of adefovir.

Abstract

BACKGROUND

Either combination treatment or monotherapy using agents with a high genetic barrier are recommended for the retreatment of chronic hepatitis B (CHB) patients. In search of reasonable treatment, we compared the efficacy and safety of lamivudine (LAM) plus adefovir (ADV) and entecavir (ETV) alone for retreatment of patients with viral relapse after cessation of ADV.

PATIENTS AND METHODS

This is a prospective controlled study, and CHB patients with HBV DNA levels more than 4 log copies/mL were enrolled. All patients were treated with either LAM plus ADV (n=30) or ETV (n=25) for 48 weeks.

RESULTS

After 12-months treatment, the biochemical response (BR) rates were 96.7% and 84.0%, the virological response (VR) rates were 96.7% and 68% in the LAM plus ADV and ETV groups respectively. Between two groups, the difference in BR was not significant, but in VR was statistically significant (p = 0.097 for BR, and p = 0.003 for VR). Eleven patients receiving LAM plus ADV had HBeAg seroconversion, as compared with 1 in patients receiving ETV alone (36.7% versus 4%, p = 0.003). During 12-months retreatment, 1 patients receiving ETV alone had virological breakthrough and detected ETV-resistance strains, while no LAM- or ADV-associated resistance strains were detected in patients receiving LAM plus ADV. All patients receiving LAM plus ADV were well tolerated, and no serious side effects were reported.

CONCLUSIONS

LAM plus ADV combination therapy is effective in retreatment of CHB patients with viral relapse after cessation of ADV, but further studies are needed to obtain long term results.  

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  • Authors+Show Affiliations

    ,

    Infectious Disease Department, No.416 Hospital of Nuclear Industry Ministry, Chengdu, China.

    ,

    Source

    MeSH

    Adenine
    Adult
    Antiviral Agents
    Case-Control Studies
    DNA, Viral
    Drug Resistance, Viral
    Drug Therapy, Combination
    Female
    Guanine
    Hepatitis B e Antigens
    Hepatitis B virus
    Hepatitis B, Chronic
    Humans
    Lamivudine
    Liver Function Tests
    Male
    Organophosphonates
    Prospective Studies
    Recurrence
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    23690184

    Citation

    TY - JOUR T1 - Comparison of re-treatment outcomes of lamivudine plus adefovir or entecavir in chronic hepatitis B patients with viral relapse after cessation of adefovir. AU - Wang,J C, AU - He,L L, AU - Chen,Q, PY - 2013/5/22/entrez PY - 2013/5/22/pubmed PY - 2013/7/20/medline SP - 1162 EP - 6 JF - European review for medical and pharmacological sciences JO - Eur Rev Med Pharmacol Sci VL - 17 IS - 9 N2 - BACKGROUND: Either combination treatment or monotherapy using agents with a high genetic barrier are recommended for the retreatment of chronic hepatitis B (CHB) patients. In search of reasonable treatment, we compared the efficacy and safety of lamivudine (LAM) plus adefovir (ADV) and entecavir (ETV) alone for retreatment of patients with viral relapse after cessation of ADV. PATIENTS AND METHODS: This is a prospective controlled study, and CHB patients with HBV DNA levels more than 4 log copies/mL were enrolled. All patients were treated with either LAM plus ADV (n=30) or ETV (n=25) for 48 weeks. RESULTS: After 12-months treatment, the biochemical response (BR) rates were 96.7% and 84.0%, the virological response (VR) rates were 96.7% and 68% in the LAM plus ADV and ETV groups respectively. Between two groups, the difference in BR was not significant, but in VR was statistically significant (p = 0.097 for BR, and p = 0.003 for VR). Eleven patients receiving LAM plus ADV had HBeAg seroconversion, as compared with 1 in patients receiving ETV alone (36.7% versus 4%, p = 0.003). During 12-months retreatment, 1 patients receiving ETV alone had virological breakthrough and detected ETV-resistance strains, while no LAM- or ADV-associated resistance strains were detected in patients receiving LAM plus ADV. All patients receiving LAM plus ADV were well tolerated, and no serious side effects were reported. CONCLUSIONS: LAM plus ADV combination therapy is effective in retreatment of CHB patients with viral relapse after cessation of ADV, but further studies are needed to obtain long term results.   SN - 1128-3602 UR - https://www.unboundmedicine.com/medline/citation/23690184/Comparison_of_re_treatment_outcomes_of_lamivudine_plus_adefovir_or_entecavir_in_chronic_hepatitis_B_patients_with_viral_relapse_after_cessation_of_adefovir_ L2 - http://www.europeanreview.org/article/3359 ER -