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KMID : 1040620150210030242
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Clinical and Molecular Hepatology
2015 Volume.21 No. 3 p.242 ~ p.248
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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
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Park Jung-Gil
Park Soo-Young
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Abstract
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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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KEYWORD
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Chronic hepatitis B, Lamivudine resistance, Combination therapy, Entecavir, Tenofovir
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