424 Durability of HBEAG seroconversion after adefovir dipivoxil treatment for chronic hepatitis B (CHB)

Chang, Ting Tsung; Shiffman, M.; Tong, Myron J.; Marcellin, Patrick; Yf, Liaw; Luengrojanakul, Pairoj; Choy, Gavin; James, Craig; Ma, Jimmy; Xiong, Sidong; Currie, G. A.; Brosgart, Carol

doi:10.1016/s0168-8278(04)90424-2

Cited by 23 publications

(14 citation statements)

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“…Histological improvement occurred regardless of baseline Knodell fibrosis score, with a greater proportion of patients regressing from portal fi brosis or cirrhosis and no worsening of fi brosis [72] . HBeAg seroconversion was durable in 90% of patients followed up for a median of 55 weeks [73] .…”

Section: Adefovirmentioning

confidence: 99%

Established and Emerging Therapies for the Treatment of Viral Hepatitis

Forton¹,

Karayiannis²

2006

Dig Dis

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Patients who are chronically infected with either hepatitis B or C viruses run the risk of developing cirrhosis and hepatocellular carcinoma in later life. Antiviral treatment offers the only means of interrupting this progression. To date, recombinant interferon alpha and the nucleos(t)ide analogues lamivudine and adefovir dipivoxil are the only licensed drugs for the treatment of chronic hepatitis B, whilst recombinant or pegylated interferons in combination with ribavirin are the ones used for chronic hepatitis C virus infections. The efficacy of these treatments, reasons for treatment failure, drug resistance and future options are discussed in the present review.

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Section: Adefovirmentioning

confidence: 99%

Established and Emerging Therapies for the Treatment of Viral Hepatitis

Forton¹,

Karayiannis²

2006

Dig Dis

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“…However, few data are available concerning the durability of ADV in treatment-naïve CHB patients. One study reported that 90% of 76 patients had sustained HBeAg seroconversion 1 year after ADV discontinuation 18. Additionally, a sustained response rate following the discontinuation of ADV after 4 or 5 years of effective ADV treatment has been reported in up to 66% of ADV treatment-naïve patients.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

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Background/AimsWe 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.MethodsThe 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 105 copies/mL.ResultsIn 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 105 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.ConclusionsDuring 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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“…Bei erfolgter HBe-Serokonversion ist der Therapieerfolg einer Nukleosid-Analoga-Therapie in über 50 -77 % der Fälle dauerhaft [100,142,237] (Ib). Für Adefovir wurde ein dauerhaftes Ansprechen nach einer mittleren Therapiedauer von 80 Wochen bei 69 von 76 Patienten (92 %) berichtet [46] (IIa). Demgegenüber ist eine dauerhafte Unterdrückung der HBV-DNA nach Therapieende einer Nukleosid-oder Nukleotid-Analoga-Therapie bei weniger als 10 % der HBeAg-negativen Patienten zu beobachten [153], wobei diese Rate bei verlängerter Therapie von mindestens 2 Jahren hçher sein kçnnte [130] (IIb).…”

Section: Konsens: 94 %unclassified