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Entecavir plus tenofovir versus entecavir plus adefovir in chronic hepatitis B patients with a suboptimal response to lamivudine and adefovir combination therapy.

Abstract

BACKGROUND/AIMS

We compared the efficacies of entecavir (ETV) plus tenofovir (TDF) and ETV plus adefovir (ADV) in chronic hepatitis B (CHB) patients with genotypic resistance to lamivudine (LAM) who showed a suboptimal response to LAM and ADV combination therapy.

METHODS

We reviewed 63 CHB patients with genotypic resistance to LAM who showed a suboptimal response to LAM and ADV combination therapy. Among these patients, 30 were treated with ETV + ADV and 33 were treated with ETV + TDF for 12 months.

RESULTS

The only baseline characteristic that differed significantly between the two groups was the ETV resistance profile. The rate of a virologic response [serum hepatitis B virus (HBV) DNA level of <20 IU/mL] was significant higher for ETV+TDF than for ETV+ADV over 12 months (57.6% vs. 23.3%, P=0.006, at 6 months; 84.8% vs. 26.7%, P<0.001, at 12 months). The probability of a virologic response was significantly increased in ETV+TDF (P<0.001, OR=54.78, 95% CI=7.15-419.54) and decreased in patients with higher baseline viral loads (P=0.001, OR=0.18, 95% CI=0.07-0.50) in multivariate analysis. No serious adverse event occurred during the study period.

CONCLUSIONS

In patients with CHB who showed a suboptimal response to LAM and ADV combination therapy, ETV+TDF was superior to ETV+ADV in achieving a virologic response regardless of the HBV resistance profile. Further large-scale and long-term follow-up prospective studies are needed to explain these results.

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  • Authors+Show Affiliations

    ,

    Division of Gastroenterology and Hepatology, Department of Internal Medicine, CHA University, CHA Gumi Medical Center, Gumi, Korea.

    Division of Gastroenterology and Hepatology, Department of Internal Medicine School of Medicine, Kyungpook National University, Daegu, Korea.

    Source

    Clinical and molecular hepatology 21:3 2015 Sep pg 242-8

    MeSH

    Adenine
    Adult
    Antiviral Agents
    DNA, Viral
    Drug Resistance, Viral
    Drug Therapy, Combination
    Female
    Genotype
    Guanine
    Hepatitis B virus
    Hepatitis B, Chronic
    Humans
    Lamivudine
    Male
    Middle Aged
    Odds Ratio
    Organophosphonates
    Real-Time Polymerase Chain Reaction
    Retrospective Studies
    Tenofovir
    Viral Load

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    26523269