Add-On Adefovir Is Superior to a Switch to Entecavir as Rescue Therapy for Lamivudine-Resistant Chronic Hepatitis B

被引：29

作者：

Chung, Goh Eun ^{[2
]}

Kim, Won ^{[1
]}

Lee, Kook Lae ^{[1
]}

Hwang, Sang Youn ^{[3
,4
]}

Lee, Jeong-Hoon ^{[3
,4
]}

Kim, Hwi Young ^{[3
,4
]}

Jung, Yong Jin ^{[1
]}

Kim, Donghee ^{[2
]}

Jeong, Ji Bong ^{[1
]}

Kim, Byeong Gwan ^{[1
]}

Kim, Yoon Jun ^{[3
,4
]}

Yoon, Jung-Hwan ^{[3
,4
]}

Lee, Hyo-Suk ^{[3
,4
]}

机构：

[1] Seoul Metropolitan Govt Seoul Natl Univ, Dept Internal Med, Boramae Med Ctr, Seoul 156707, South Korea

[2] Seoul Natl Univ Hosp, Dept Internal Med, Gangnam Healthcare Ctr, Seoul 110744, South Korea

[3] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul 151, South Korea

[4] Seoul Natl Univ, Coll Med, Liver Res Inst, Seoul 151, South Korea

来源：

DIGESTIVE DISEASES AND SCIENCES | 2011年 / 56卷 / 07期

关键词：

Adefovir; Entecavir; Rescue therapy; Chronic hepatitis B; HEPATOCELLULAR-CARCINOMA; RISK; DIPIVOXIL; COMBINATION; SUBSTITUTIONS; MONOTHERAPY; EFFICACY; DNA;

D O I：

10.1007/s10620-010-1561-2

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Lamivudine (LAM) has been extensively used to treat hepatitis B, but high incidence of drug resistance has required rescue studies. We validated the optimum treatment strategy for LAM-resistant patients by means of a comparative study of add-on adefovir (ADV) and a switch to entecavir (ETV). We assessed the virologic response in consecutive LAM-resistant patients who received add-on ADV or a switch to ETV. The mean reduction of serum hepatitis B virus (HBV) DNA levels was significantly less in the ETV group than in the add-on ADV group (-3.45 vs. -4.17; P = 0.047 at week 24 and -3.81 vs. -4.68 log(10) IU/mL; P = 0.044 at week 48). Achievement of undetectable HBV DNA was significantly lower in the ETV group than in the add-on ADV group (P = 0.043). Multivariate analysis showed that add-on ADV, baseline HBV DNA levels, and initial virologic response were significant predictors of HBV DNA negativity (adjusted OR, 2.582; P = 0.008, 0.304; P = 0.001, and 5.928; P = 0.001). Virologic breakthrough was observed for 12 patients, in the ETV group only. Add-on ADV was more effective and durable than ETV as rescue therapy. Therefore, add-on ADV might be the preferred strategy for LAM-resistant patients who need long-term antiviral treatment.

引用

页码：2130 / 2136

页数：7

共 23 条

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