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KMID : 1040620160220020241
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Clinical and Molecular Hepatology
2016 Volume.22 No. 2 p.241 ~ p.249
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The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy
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Kim Jeong-Han
Ahn Sung-Hyun
Ko Soon-Young
Choe Won-Hyeok
Kim Kyun-Hwan
Kwon So-Young
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Abstract
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Background/Aims: Before tenofovir (TDF) become available in South Korea, combination therapy with entecavir (ETV) and adefovir (ADV) was the most potent regimen for chronic hepatitis B (CHB) patients who fail to respond to rescue therapy for drug resistance. We analyzed the efficacy of ETV-ADV combination therapy and investigated the clinical and clonal results of TDF-based rescue therapy in CHB patients refractory to this combination.
Methods: We retrospectively reviewed the medical records of CHB patients treated for up to 3 years with ETV-ADV combination therapy as a rescue therapy for drug resistance. In cases refractory to this combination, clinical and clonal analyses were performed for TDF-based rescue therapy.
Results: The analysis was performed on 48 patients. Twelve patients achieved a virological response (VR) within 3 years. A VR was subsequently achieved in nine of the ten patients without a VR who switched to TDF monotherapy. A VR was also achieved in six of the seven patients who switched to lamivudine-TDF combination therapy, and in two of the two patients who switched to ETV-TDF combination therapy. In an in vitro susceptibility test, viral replication was detected with TDF monotherapy but not with ETV-TDF combination therapy.
Conclusions: The efficacy of ETV-ADV combination therapy was insufficient in CHB patients who were refractory to rescue therapy. A more potent regimen such as ETV-TDF combination therapy may be considered in such refractory cases.
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KEYWORD
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Chronic Hepatitis B, Entecavir, Adefovir, Lamivudine, Tenofovir, Resistance
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