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Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients

BACKGROUND/AIMS: We investigated the durability of the biochemical and virologic responses after adefovir (ADV) discontinuation in lamivudine-resistant (LMV-R) chronic hepatitis B (CHB) patients, and the outcomes of ADV discontinuation compared to that of ADV maintenance. METHODS: The indication for...

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Autores principales: Jung, Young Kul, Yeon, Jong Eun, Lee, Kwang Gyun, Jung, Eun Seok, Kim, Jeong Han, Kim, Ji Hoon, Seo, Yeon Seok, Yim, Hyung Joon, Um, Sun Ho, Ryu, Ho Sang, Byun, Kwan Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association for the Study of the Liver 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304672/
https://www.ncbi.nlm.nih.gov/pubmed/22310790
http://dx.doi.org/10.3350/kjhep.2011.17.4.261
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author Jung, Young Kul
Yeon, Jong Eun
Lee, Kwang Gyun
Jung, Eun Seok
Kim, Jeong Han
Kim, Ji Hoon
Seo, Yeon Seok
Yim, Hyung Joon
Um, Sun Ho
Ryu, Ho Sang
Byun, Kwan Soo
author_facet Jung, Young Kul
Yeon, Jong Eun
Lee, Kwang Gyun
Jung, Eun Seok
Kim, Jeong Han
Kim, Ji Hoon
Seo, Yeon Seok
Yim, Hyung Joon
Um, Sun Ho
Ryu, Ho Sang
Byun, Kwan Soo
author_sort Jung, Young Kul
collection PubMed
description BACKGROUND/AIMS: We investigated the durability of the biochemical and virologic responses after adefovir (ADV) discontinuation in lamivudine-resistant (LMV-R) chronic hepatitis B (CHB) patients, and the outcomes of ADV discontinuation compared to that of ADV maintenance. METHODS: The indication for ADV treatment cessation was an undetectable level of hepatitis B virus (HBV) DNA documented on two occasions at least 6 months apart. All patients received additional ADV for at least 12 months after the confirmation of undetectable HBV DNA (Cobas TaqMan PCR assay, <70 copies/mL). Of 36 patients who had a sufficient ADV therapeutic effect, 19 discontinued ADV treatment, while the others maintained it. A virologic rebound was arbitrarily defined as the redetection of HBV DNA at a level higher than 10(5) copies/mL. RESULTS: In the ADV discontinuation group, ADV treatment and additional therapy were administered for medians of 33 months (range, 12-47 months) and 18 months, respectively. The patients were followed for a median of 12 months (range, 3-30 months) after ADV cessation. During that period, 18 of 19 patients (95%) experienced viral relapse. Viral rebound was observed in six patients (32%). However, 12 of 18 patients (67%) exhibited serum HBV DNA levels of less than 10(5) copies/mL. Biochemical relapses were observed in four of the six patients with viral rebound. In the ADV maintenance group, patients were treated for a median of 53 months (range, 31-85 months), and 9 patients (53%) experienced viral breakthrough. CONCLUSIONS: During short-term follow-up after ADV discontinuation, most patients (95%) exhibited viral relapse, whereas and viral breakthrough occurred in about half of patients (53%) maintained on ADV therapy. Therefore, the durability of virologic response after ADV discontinuation in LMV-R patients was unsatisfactory. In addition, and viral breakthrough was not infrequent in the ADV continuation group.
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spelling pubmed-33046722012-03-20 Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients Jung, Young Kul Yeon, Jong Eun Lee, Kwang Gyun Jung, Eun Seok Kim, Jeong Han Kim, Ji Hoon Seo, Yeon Seok Yim, Hyung Joon Um, Sun Ho Ryu, Ho Sang Byun, Kwan Soo Korean J Hepatol Original Article BACKGROUND/AIMS: We investigated the durability of the biochemical and virologic responses after adefovir (ADV) discontinuation in lamivudine-resistant (LMV-R) chronic hepatitis B (CHB) patients, and the outcomes of ADV discontinuation compared to that of ADV maintenance. METHODS: The indication for ADV treatment cessation was an undetectable level of hepatitis B virus (HBV) DNA documented on two occasions at least 6 months apart. All patients received additional ADV for at least 12 months after the confirmation of undetectable HBV DNA (Cobas TaqMan PCR assay, <70 copies/mL). Of 36 patients who had a sufficient ADV therapeutic effect, 19 discontinued ADV treatment, while the others maintained it. A virologic rebound was arbitrarily defined as the redetection of HBV DNA at a level higher than 10(5) copies/mL. RESULTS: In the ADV discontinuation group, ADV treatment and additional therapy were administered for medians of 33 months (range, 12-47 months) and 18 months, respectively. The patients were followed for a median of 12 months (range, 3-30 months) after ADV cessation. During that period, 18 of 19 patients (95%) experienced viral relapse. Viral rebound was observed in six patients (32%). However, 12 of 18 patients (67%) exhibited serum HBV DNA levels of less than 10(5) copies/mL. Biochemical relapses were observed in four of the six patients with viral rebound. In the ADV maintenance group, patients were treated for a median of 53 months (range, 31-85 months), and 9 patients (53%) experienced viral breakthrough. CONCLUSIONS: During short-term follow-up after ADV discontinuation, most patients (95%) exhibited viral relapse, whereas and viral breakthrough occurred in about half of patients (53%) maintained on ADV therapy. Therefore, the durability of virologic response after ADV discontinuation in LMV-R patients was unsatisfactory. In addition, and viral breakthrough was not infrequent in the ADV continuation group. The Korean Association for the Study of the Liver 2011-12 2011-12-26 /pmc/articles/PMC3304672/ /pubmed/22310790 http://dx.doi.org/10.3350/kjhep.2011.17.4.261 Text en Copyright © 2011 by The Korean Association for the Study of the Liver http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jung, Young Kul
Yeon, Jong Eun
Lee, Kwang Gyun
Jung, Eun Seok
Kim, Jeong Han
Kim, Ji Hoon
Seo, Yeon Seok
Yim, Hyung Joon
Um, Sun Ho
Ryu, Ho Sang
Byun, Kwan Soo
Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients
title Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients
title_full Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients
title_fullStr Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients
title_full_unstemmed Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients
title_short Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients
title_sort virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis b patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304672/
https://www.ncbi.nlm.nih.gov/pubmed/22310790
http://dx.doi.org/10.3350/kjhep.2011.17.4.261
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