Selection of an entecavir-resistant mutant despite prolonged hepatitis B virus DNA suppression, in a chronic hepatitis B patient with preexistent lamivudine resistance: successful rescue therapy with tenofovir

Leemans, Wilhelmus F.; Niesters, Hubert G. M.; Eijk, Annemiek A. van der; Janssen, Harry L.A.; Schalm, Solko W.; Man, Robert A. de

doi:10.1097/meg.0b013e3282f793d6

Cited by 26 publications

(21 citation statements)

References 37 publications

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“…[7][8][9] The combination of potent viral suppression and sustained efficiency against drug-resistant mutants renders tenofovir an attractive candidate for rescue treatment in chronically HBV-infected patients. 2,[10][11][12] Occurrence of tenofovir resistance, conversely, was very rarely observed in large trials of HBV-infected patients.…”

mentioning

confidence: 99%

The rtA194T polymerase mutation impacts viral replication and susceptibility to tenofovir in hepatitis B e antigen–positive and hepatitis B e antigen–negative hepatitis B virus strains #

et al. 2009

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The rtA194T polymerase mutation is associated with partial tenofovir drug resistance and negatively impacts replication competence of HBV constructs. Viral replication, however, can be restored to WT levels, if these polymerase mutations occur together with precore or basic core promoter substitutions as found in HBeAg-negative hepatitis B. Patients with HBeAg-negative chronic HBV infection may therefore be at particular risk when developing drug resistance to tenofovir. Telbivudine or entecavir should be considered as effective alternative treatment options for these patients.

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confidence: 99%

The rtA194T polymerase mutation impacts viral replication and susceptibility to tenofovir in hepatitis B e antigen–positive and hepatitis B e antigen–negative hepatitis B virus strains #

et al. 2009

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“…On the basis of therapy outcomes, TDF has proven to be a good treatment option for entecavir-resistant patients. 53 The future management of CHB appears to be more promising than ever before, with many therapeutic options currently available, new drugs in development, and different on-treatment strategies for optimizing the use of current agents undergoing investigation.…”

Section: Tenofovir Resistancementioning

confidence: 99%

Tenofovir and its potential in the treatment of hepatitis B virus

Reynaud

Carleo²,

Talamo³

et al. 2009

TCRM

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Recent literature is reviewed about treatment of chronic hepatitis B virus (CHB), focusing on tenofovir disoproxil fumarate (TDF; Viread ® ), among the nucleotide and nucleoside analogs. TDF pharmacokinetics and pharmacodynamics, activity in respect of hepatitis B virus (HBV) multi-drug-resistant mutations, effi cacy in treatment-naïve and treatment-experienced patients, and side effects are described. The most predictive response factors to TDF therapy are discussed and all available combination therapies to optimize clinical outcome in the various patient profi les are analyzed, such as compensated and/or decompensated cirrhotic patients. The use of TDF in pregnancy, and prophylaxis after exposure to HBV and post-liver transplantation are also evaluated.

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“…Only one case report has examined the issue of therapy for entecavir-resistant patients [34]. In this study, a patient who had developed M204V, L180M, and S202G mutations was successfully treated with tenofovir monotherapy.…”

Section: Entecavir-experienced and Multidrug-resistant Patientsmentioning

confidence: 99%

Role of combination therapy in chronic hepatitis B

Scott

McMahon²

2009

Curr Gastroenterol Rep

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Combination therapy includes the use of two or more antivirals for the treatment of chronic hepatitis B. No study has shown that combination therapy is superior to monotherapy in naive patients for achieving treatment end points, but combination appears to result in a lower incidence of resistance. Moreover, the higher-potency compounds have not yet been studied. Consideration should be given to treating lamivudine-resistant patients with combination therapy, preferably with a nucleotide analogue in conjunction with a nucleoside analogue. Combination therapy should be considered in patients with decompensated cirrhosis who are unable to achieve an undetectable viral level on monotherapy and in naive patients who still have a detectable viral level 6 to 12 months after starting therapy.

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Selection of an entecavir-resistant mutant despite prolonged hepatitis B virus DNA suppression, in a chronic hepatitis B patient with preexistent lamivudine resistance: successful rescue therapy with tenofovir

Cited by 26 publications

References 37 publications

The rtA194T polymerase mutation impacts viral replication and susceptibility to tenofovir in hepatitis B e antigen–positive and hepatitis B e antigen–negative hepatitis B virus strains #

The rtA194T polymerase mutation impacts viral replication and susceptibility to tenofovir in hepatitis B e antigen–positive and hepatitis B e antigen–negative hepatitis B virus strains #

Tenofovir and its potential in the treatment of hepatitis B virus

Role of combination therapy in chronic hepatitis B

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