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Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B

BACKGROUND/AIMS: The incidence of multidrug-resistant (MDR) chronic hepatitis B (CHB) during sequential lamivudine (LAM) and adefovir dipivoxil (ADV) treatment is increasing. We investigated the antiviral efficacies of various rescue regimens in patients who failed sequential LAM-ADV treatment. METH...

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Autores principales: Park, Mi Sung, Kim, Beom Kyung, Kim, Kyung Sik, Kim, Ja Kyung, Kim, Seung Up, Park, Jun Yong, Kim, Do Young, Baartarkhuu, Oidov, Han, Kwang Hyub, Chon, Chae Yoon, Ahn, Sang Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association for the Study of the Liver 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622853/
https://www.ncbi.nlm.nih.gov/pubmed/23593607
http://dx.doi.org/10.3350/cmh.2013.19.1.29
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author Park, Mi Sung
Kim, Beom Kyung
Kim, Kyung Sik
Kim, Ja Kyung
Kim, Seung Up
Park, Jun Yong
Kim, Do Young
Baartarkhuu, Oidov
Han, Kwang Hyub
Chon, Chae Yoon
Ahn, Sang Hoon
author_facet Park, Mi Sung
Kim, Beom Kyung
Kim, Kyung Sik
Kim, Ja Kyung
Kim, Seung Up
Park, Jun Yong
Kim, Do Young
Baartarkhuu, Oidov
Han, Kwang Hyub
Chon, Chae Yoon
Ahn, Sang Hoon
author_sort Park, Mi Sung
collection PubMed
description BACKGROUND/AIMS: The incidence of multidrug-resistant (MDR) chronic hepatitis B (CHB) during sequential lamivudine (LAM) and adefovir dipivoxil (ADV) treatment is increasing. We investigated the antiviral efficacies of various rescue regimens in patients who failed sequential LAM-ADV treatment. METHODS: Forty-eight patients (83.3% of whom were HBeAg-positive) who failed sequential LAM-ADV treatment were treated with one of the following regimens: entecavir (ETV) (1 mg) monotherapy (n=16), LAM+ADV combination therapy (n=20), or ETV (1 mg)+ADV combination therapy (n=12). All patients had confirmed genotypic resistance to both LAM and ADV and were evaluated every 12 weeks. RESULTS: The baseline characteristics and treatment duration did not differ significantly among the study groups. During the treatment period (median duration: 100 weeks), the decline of serum HBV DNA from baseline tended to be greatest in the ETV+ADV group at all-time points (week 48: -2.55 log(10) IU/mL, week 96: -4.27 log(10) IU/mL), but the difference was not statistically significant. The ETV+ADV group also tended to have higher virologic response rates at 96 weeks compared to the ETV monotherapy or LAM+ADV groups (40.0% vs. 20.0% or 20.0%, P=0.656), and less virologic breakthrough was observed compared to the ETV monotherapy or LAM+ADV groups (8.3% vs. 37.5% or 30.0%; P=0.219), but again, the differences were not statistically significant. HBeAg loss occurred in one patient in the ETV+ADV group, in two in the ETV monotherapy group, and in none of the LAM+ADV group. The safety profiles were similar in each arm. CONCLUSIONS: There was a nonsignificant tendency toward better antiviral efficacy with ETV+ADV combination therapy compared to LAM+ADV combination therapy and ETV monotherapy for MDR CHB in Korea, where tenofovir is not yet available.
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spelling pubmed-36228532013-04-16 Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B Park, Mi Sung Kim, Beom Kyung Kim, Kyung Sik Kim, Ja Kyung Kim, Seung Up Park, Jun Yong Kim, Do Young Baartarkhuu, Oidov Han, Kwang Hyub Chon, Chae Yoon Ahn, Sang Hoon Clin Mol Hepatol Original Article BACKGROUND/AIMS: The incidence of multidrug-resistant (MDR) chronic hepatitis B (CHB) during sequential lamivudine (LAM) and adefovir dipivoxil (ADV) treatment is increasing. We investigated the antiviral efficacies of various rescue regimens in patients who failed sequential LAM-ADV treatment. METHODS: Forty-eight patients (83.3% of whom were HBeAg-positive) who failed sequential LAM-ADV treatment were treated with one of the following regimens: entecavir (ETV) (1 mg) monotherapy (n=16), LAM+ADV combination therapy (n=20), or ETV (1 mg)+ADV combination therapy (n=12). All patients had confirmed genotypic resistance to both LAM and ADV and were evaluated every 12 weeks. RESULTS: The baseline characteristics and treatment duration did not differ significantly among the study groups. During the treatment period (median duration: 100 weeks), the decline of serum HBV DNA from baseline tended to be greatest in the ETV+ADV group at all-time points (week 48: -2.55 log(10) IU/mL, week 96: -4.27 log(10) IU/mL), but the difference was not statistically significant. The ETV+ADV group also tended to have higher virologic response rates at 96 weeks compared to the ETV monotherapy or LAM+ADV groups (40.0% vs. 20.0% or 20.0%, P=0.656), and less virologic breakthrough was observed compared to the ETV monotherapy or LAM+ADV groups (8.3% vs. 37.5% or 30.0%; P=0.219), but again, the differences were not statistically significant. HBeAg loss occurred in one patient in the ETV+ADV group, in two in the ETV monotherapy group, and in none of the LAM+ADV group. The safety profiles were similar in each arm. CONCLUSIONS: There was a nonsignificant tendency toward better antiviral efficacy with ETV+ADV combination therapy compared to LAM+ADV combination therapy and ETV monotherapy for MDR CHB in Korea, where tenofovir is not yet available. The Korean Association for the Study of the Liver 2013-03 2013-03-25 /pmc/articles/PMC3622853/ /pubmed/23593607 http://dx.doi.org/10.3350/cmh.2013.19.1.29 Text en Copyright © 2013 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
Park, Mi Sung
Kim, Beom Kyung
Kim, Kyung Sik
Kim, Ja Kyung
Kim, Seung Up
Park, Jun Yong
Kim, Do Young
Baartarkhuu, Oidov
Han, Kwang Hyub
Chon, Chae Yoon
Ahn, Sang Hoon
Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B
title Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B
title_full Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B
title_fullStr Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B
title_full_unstemmed Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B
title_short Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B
title_sort antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis b
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622853/
https://www.ncbi.nlm.nih.gov/pubmed/23593607
http://dx.doi.org/10.3350/cmh.2013.19.1.29
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