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KMID : 1103920090150010052
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Korean Journal of Hepatology
2009 Volume.15 No. 1 p.52 ~ p.58
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Virologic response to adefovir dipivoxil monotherapy is not durable in HBeAg-positive, lamivudine-resistant chronic hepatitis B patients
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Jung Hyun-Wook
Choi Moon-Seok
Koh Kwang-Cheol
Yoo Byung-Chul
Lee Joon-Hyoek
Gwak Geum-Youn
Paik Seung-Woon
Park Sung- Hyun
Kim Kap-Hyun
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Abstract
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Backgrounds/Aims:It has been shown that adefovir dipivoxil is an effective antiviral agent in the treatment of chronic hepatitis B (CHB), not only in wild-type hepatitis B virus (HBV) infection, but also in lamivudine-resistant (LAMV-R) cases. However, little is known about the durability of the virologic response to adefovir in LAMV-R CHB patients.
Methods:Fifteen HBV e-antigen (HBeAg)-positive, LAMV-R CHB patients showed a virologic response to adefovir monotherapy. These patients received additional adefovir for at least a further 12 months. The virologic relapse rate after discontinuation of adefovir was evaluated. In addition, predictive factors associated with virologic relapse were investigated.
Results:The median level of serum HBV DNA before adefovir administration was 7,457,840 IU/mL (range 107,920-99,524,960 IU/mL). The median duration of adefovir treatment was 30 months (range 14-46 months). During a median follow-up period of 14 months after discontinuation of adefovir, the 1-, 2-, 3-, 6-, and 12-month cumulative relapse rates were 26.7%, 53.3%, 73.3%, 80%, and 80%, respectively. High pretreatment HBV DNA levels were found to be the only factor that was predictive of off-therapy relapse.
Conslusions:Our data suggest that the adefovir-monotherapy-induced virologic response is not durable in most patients with LAMV-R HBeAg-positive CHB, especially in those with a high pretreatment HBV DNA level.
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KEYWORD
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Adefovir dipivoxil, Lamivudine, Drug Resistance, Viral, Durability.
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