Long-Term Therapy with Adefovir Dipivoxil for HBeAg-Negative Chronic Hepatitis B

Hadziyannis, Stephanos J.; Tassopoulos, Nicolaos C.; Heathcote, E. Jenny; Chang, Ting‐Tsung; Kitis, G.; Rizzetto, M.; Marcellin, Patrick; Lim, Seng Gee; Goodman, Zachary; Ma, Jin; Arterburn, Sarah; Xiong, Shelly; Currie, Graeme; Brosgart, Carol

doi:10.1056/nejmoa042957

Cited by 500 publications

(396 citation statements)

References 17 publications

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“…In another study [30], after a total of 3 years of lamivudine treatment, 56% of patients showed at least a 2-point improvement in histologic activity index scores, bridging fibrosis improved by at least 1 point in 63% and cirrhosis improved in 73% (score reduced from 4 to 3 or lower). Similar improvements in histology have been shown for adefovir [31] and entecavir [32,33] treatment also. These studies demonstrate that fibrosis, and even cirrhosis, are partially reversible with long-term nucleos(t)ide treatment that suppresses HBV DNA to low or undetectable levels.…”

Section: Hbvdna As a Prognostic Markersupporting

confidence: 76%

Should chronic HBV infected patients with normal ALT treated: debate

Sarin

Kumar

2008

Hepatol Int

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Alanine aminotransferase (ALT) levels have traditionally been used for treatment decisions in chronic hepatitis B virus (CHBV) infected patients. But recent data have raised doubts on this wisdom, as a significant proportion of CHBV infected patients with normal ALT have high HBVDNA levels and significant liver injury at presentation especially in areas of intermediate to high endemicity. A normal ALT value only identifies patients less likely to respond to current treatments, rather than patients who are not in need of the treatment. Patients with CHBV infection with normal ALT should be considered for treatment based on the HBV DNA levels and histological injury.

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Section: Hbvdna As a Prognostic Markersupporting

confidence: 76%

Should chronic HBV infected patients with normal ALT treated: debate

Sarin

Kumar

2008

Hepatol Int

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“…Genotypic resistance occurs in approximately 20% of patients per year in lamivudine treated patients 10,11 , and at a Villet 4 lower rate in adefovir treated patients, i.e. 3% at year two with a progressive increase to 29% at year five of therapy 12 .…”

Section: Chronic Hepatitis B Virus (Hbv) Infection Remains a Major Hementioning

confidence: 99%

Selection of a Multiple Drug-Resistant Hepatitis B Virus Strain in a Liver-Transplanted Patient

et al. 2006

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“…Although resistance to ADV is slow to emerge, resistant variants increase progressively after the first year, reaching 29% in year five [16]. The advantages of ADV are its limited resistance during first two years, the absence of cross-resistance with LAM and other L-nucleosides and, therefore, its value as treatment for LAM-resistant CHB [17][18] and for hepatic decompensation associated with LAM resistance prior to and after liver transplantation [19].…”

Section: Section I: Published Results Based On the Consensus Of Eamentioning

confidence: 99%

Recent Advances in the Management of Chronic Hepatitis B

et al. 2011

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There are seven approved treatments for adults with chronic hepatitis B virus infection in the United States and European countries: interferon-α, pegylated interferon-α, lamivudine, adefovir dipivoxil, entecavir, telbivudine, and tenofovir disoproxil fumarate. At present, two new analogues, entecavir and tenofovir are recommended as the first line therapy by the guidelines of European Association for the Study of the Liver and American Association Study for the Liver Diseases. On the other hand, regarding interferon therapy, use of pegylated interferon-α is recommended as the first line therapy instead of standard interferon-α by both guidelines. Therefore, the main scientific interests and unmet medical needs for treatment of chronic hepatitis B have been narrowed down to long-term efficacy and safety of the two said analogues-entecavir and tenofovir-and combination therapy of pegylated interferon-α with the two analogues. To put it concretely, further studies are needed to assess (1) the long-term efficacy and safety and resistance to entecavir and tenofovir; (2) the efficacy of different durations (24 weeks to 2 years) and lower doses of pegylated interferon-α; (3) the role of combination therapy with two analogues to reduce resistance; and (4) the efficacy and safety of the two analogues with decompensated cirrhosis. Herein, we review the recent available data and results.

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Long-Term Therapy with Adefovir Dipivoxil for HBeAg-Negative Chronic Hepatitis B

Abstract: In patients with HBeAg-negative chronic hepatitis B, the benefits achieved from 48 weeks of adefovir dipivoxil were lost when treatment was discontinued. In patients treated for 144 weeks, benefits were maintained, with infrequent emergence of viral resistance.

Cited by 500 publications

References 17 publications

Should chronic HBV infected patients with normal ALT treated: debate

Should chronic HBV infected patients with normal ALT treated: debate

Selection of a Multiple Drug-Resistant Hepatitis B Virus Strain in a Liver-Transplanted Patient

Recent Advances in the Management of Chronic Hepatitis B

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