Low Resistance to Adefovir Combined With Lamivudine: A 3-Year Study of 145 Lamivudine-Resistant Hepatitis B Patients

Lampertico, Pietro; Viganò, Mauro; Manenti, E.; Iavarone, M.; Sablon, Erwin; Colombo, M.

doi:10.1053/j.gastro.2007.08.079

Cited by 280 publications

(286 citation statements)

References 26 publications

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“…11,25,26 Even though rescue treatments are available for resistant cases, good viral suppression is not always attained. 27,28 In addition to monitor the emergency of resistance, it is also recommended to identify patients with high risk of developing resistance during treatment, and modify the therapeutic regimen as soon as possible.…”

Section: Drug Resistancementioning

confidence: 99%

Response predictors to treatment with pegylated interferon in chronic hepatitis B

Ferreira

Tenore

2010

Braz J Infect Dis

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The clinical and epidemiological importance of chronic B hepatitis is currently unquestionable as a cause of end-stage liver disease and hepatocellular carcinoma. Recently, predictors of treatment response of this disease have been studied, both before and during the course of medication. Therapy stopping rules have been proposed, which may be useful in patients presenting poor treatment tolerance. This review discusses the treatment response predictors usefulness, with emphasis on ALT, quantitative HBsAg and HBeAg, quantitative HBV-DNA and HBV genotyp

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Section: Drug Resistancementioning

confidence: 99%

Response predictors to treatment with pegylated interferon in chronic hepatitis B

Ferreira

Tenore

2010

Braz J Infect Dis

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“…The APASL guidelines recommend the addition of ADV for patients with lamivudine resistance [9]. Lamivudine-resistant mutations remain sensitive to ADV, and adding, rather than switching to, ADV, reduces the potential for the subsequent development of ADV resistance [44][45][46]. Switching to entecavir is also an option [9], although the development of entecavir resistance is accelerated in patients with pre-existing lamivudine-resistant mutations [30].…”

Section: Discussionmentioning

confidence: 99%

A review of the one-year incidence of resistance to lamivudine in the treatment of chronic hepatitis B

Hann

Gregory²,

Dixon

et al. 2008

Hepatol Int

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Purpose The development of antiviral resistance is a recognized challenge to successful treatment of chronic hepatitis B (CHB), but it has been difficult to establish an accurate estimate of its incidence due to a number of factors: (a) lack of an accepted definition of antiviral resistance; (b) lack of a standardized assay to assess resistance; and (c) lack of consensus on patient selection criteria for resistance testing. Lamivudine, an effective and well-established antiviral agent, has been reported to show one-year resistance rates in CHB ranging from 6% to 32%, but methodologies used to calculate these rates vary considerably. This article reviews the clinical, statistical, and laboratory methodologies of clinical studies reporting oneyear rates of antiviral resistance to lamivudine in CHB. Methods Studies reporting one-year resistance rates to lamivudine in CHB were analyzed for methodologic differences and their influence on reported resistance rates.Results Studies using only a genotypic definition of resistance reported one-year rates ranging from 14% to 32%. Studies assessing genotypic resistance in patients with evidence of virologic breakthrough reported much lower one-year resistance rates of 6.4-15.4%. Conclusions It is important when comparing resistance rates to antiviral drugs in CHB to consider the methodology and definition of resistance used because this can dramatically influence the results.

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“…Subsequently, 17 studies met all the inclusion criteria following a systematic review ( Fig. 1) (3,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Of the 17 studies, seven were RCTs (3,(9)(10)(11)(12)(13)(14), four were cohort studies (15)(16)(17)(18) and the remaining six were single-arm studies (5,(19)(20)(21)(22)(23).…”

Section: Characteristics Of the Enrolled Studies And Qualitymentioning

confidence: 99%

“…The baseline characteristics and quality assessment of the publications are shown in Tables I-III. Thirty-five percent of the studies were performed in multiple countries (3,(9)(10)(11)(12)15), 41.2% were in Asia (5,16-18,21-23) and 23.5% were in Europe (13,14,19,20). Of the studies included, the follow-up period of six studies lasted for ~1 year (3,9-12,18), 10 for 2-5 years (5,(14)(15)(16)(17)(19)(20)(21)(22)(23) and one for <7.5 years (13).…”

Section: Characteristics Of the Enrolled Studies And Qualitymentioning

confidence: 99%

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Association between adefovir dipivoxil treatment and the risk of renal insufficiency in patients with chronic hepatitis B: A meta-analysis

et al. 2015

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Abstract. Adefovir dipivoxil (ADV) is an effective antiviral drug against hepatitis B virus. The renal tolerance of ADV at the currently approved dose of 10 mg daily for the treatment of chronic hepatitis B (CHB) remains controversial. The present meta-analysis was therefore performed to evaluate the renal safety of ADV treatment in patients with CHB. Two independent investigators searched MEDLINE, Embase and China National Knowledge Infrastructure databases for eligible studies published in English or Chinese until June 1, 2014. The Peto odds ratios (Peto ORs) or the rates of each study were analyzed. Seven randomized controlled trials (RCTs), four cohort studies and six single-arm studies were identified. ADV treatment was not associated with a higher incidence of nephrotoxicity in RCTs [Peto OR, 1.781; 95% confidence interval (CI), 0.637-4.979; P=0.271] but appeared to increase nephrotoxicity significantly in cohort studies (Peto OR, 2.682; 95% CI, 1.470-4.894; P=0.001); the significant increase was further observed in CHB patients receiving long-term ADV treatment in cohort studies (Peto OR, 2.275; 95% CI, 1.127-4.593; P=0.022). The analysis based on single-arm studies showed that the rate of renal dysfunction in the ADV-treated patients was 10.6% (95% CI, 0.059-0.185); the subgroup analysis with the standard of createnine levels showed a lower rate (6.9%, 95% CI, 0.013-0.298) than those in the overall studies. In conclusion, although current evidence indicated a positive link between treatment with ADV in CHB patients and an increased risk of renal dysfunction, optimally designed studies are required for definitive conclusions.

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Low Resistance to Adefovir Combined With Lamivudine: A 3-Year Study of 145 Lamivudine-Resistant Hepatitis B Patients

Cited by 280 publications

References 26 publications

Response predictors to treatment with pegylated interferon in chronic hepatitis B

Response predictors to treatment with pegylated interferon in chronic hepatitis B

A review of the one-year incidence of resistance to lamivudine in the treatment of chronic hepatitis B

Association between adefovir dipivoxil treatment and the risk of renal insufficiency in patients with chronic hepatitis B: A meta-analysis

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