Virologic Response at 12 Months of Treatment Predicts Sustained Antiviral Efficacy in Patients with Adefovir-Treated Lamivudine-Resistant Chronic Hepatitis B

Jung, Young Kul; Yeon, Jong Eun; Han, Woo Sik; Kim, Ji Hoon; Kim, Jeong Han; Park, Jong Jae; Kim, Jae Seon; Bak, Young Tae; Yoo, Won Sang; Hong, Sun; Kim, Soo Ok; Kwon, So Young; Byun, Kwan Soo; Lee, Chang Hong

doi:10.5009/gnl.2010.4.2.212

Cited by 3 publications

(5 citation statements)

References 30 publications

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“…Gender was not reported to seemingly affect the response to adefovir treatment except one study which shows that the virologic response to adefovir was better in female patients (Kin et al, 2011;Jung et al, 2010;Aizawa et al, 2011;Reijnders et al, 2009;Ong et al, 2011;Wang et al, 2011;Buti et al, 2007). There was no effect of gender in response to the adefovir treatment in our study.…”

Section: Discussioncontrasting

confidence: 62%

“…It has been observed that the probability of virologic response to adefovir treatment was decreased in HBeAgpositive patients (Jung et al, 2010;Reijnders et al, 2009;Wang et al, 2011;Buti et al, 2007). Furthermore, in our study, virologic response to adefovir treatment was better in patients with HBeAg-negativity than patients with HBeAg positivity.…”

Section: Discussionsupporting

confidence: 57%

“…We explain this inconsistency with that pretreatment serum HBV DNA levels in some patients which were measured with hybrid capture 2 (a method with a low level of sensitivity) in our study and so, numbers of the patient with lower serum HBV DNA levels were small. We observed that the pretreatment serum ALT level was not a variable determining the response to adefovir treatment which is in contrast to literature (Jung et al, 2010;Aizawa et al, 2011;Reijnders et al, 2009). We think that this might be explained with the fluctuation of serum ALT levels in patients with chronic HBV infection, and also we used only one measurement of those levels instead of the mean of the at least three separate measurements.…”

Section: Discussionmentioning

confidence: 56%

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Variables determining the virologic response to adefovir treatment in patients with chronic HBV infection previously treated with lamivudine

Ceylan¹,

Fincancı²,

Müderrisoğlu³

et al. 2013

Afr. J. Microbiol. Res.

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The objective of this study was the investigation of the variables that determine the development of virological response to adefovir treatment. In this retrospective case-control study, files of patients with chronic HBV infection which previously used adefovir throughout different periods were examined for gender, age, height, weight, Knodell and fibrosis scores in liver biopsies, serum ALT and HBV DNA levels, HBeAg status and alcohol use. Independent variables determining the virologic response to adefovir treatment were investigated. This study included 63 patients. Forty-one (65.1%) of the patients were male, and their median ages were 42 (range 19 to 65). Twenty-five (39.7%) of the study population were HBeAg positive. The cumulative virological response rates on the 6 th , 12 th , 18 th , 24 th , 30 th and 36 th months of adefovir therapy were found to be 31.7, 38.4, 38.4, 44, 44 and 58%, respectively. HBeAg negativity and the ratio of decrease in serum HBV DNA levels at 6 th month of the treatment were the independent variables determining the response to the adefovir treatment [Odds ratio (95% confidence intervals) were 4.498 (1.194-16.939) for HBeAg negativity (p=0,026) and 1.598 (1.232-2.072) for the ratio of decrease in serum HBV DNA levels at 6 th month of the treatment (p=0.0001). It was suggested that adefovir was more effective in HBeAg negative patients, and was more rational to continue the treatment in patients who had a decrease of at least 2log 10 units in serum HBV DNA levels at 6 th month of treatment.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 56%

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Variables determining the virologic response to adefovir treatment in patients with chronic HBV infection previously treated with lamivudine

Ceylan¹,

Fincancı²,

Müderrisoğlu³

et al. 2013

Afr. J. Microbiol. Res.

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“…So, according to their economic conditions, these patients had only the option of self-paid LAM and insurance-covered ADV for the LAM + ADV combination therapy or a discontinuation of LAM with insurance-paid ADV monotherapy [23,25]. Therefore, after achieving VR, many were willing to discontinue the self-paid LAM.…”

Section: Introductionmentioning

confidence: 99%

The Feasibility of Discontinuing Lamivudine in Lamivudine-Resistant Chronic Hepatitis B Patients on Lamivudine and Adefovir Combination Therapy

Chung¹,

Byoun²,

Kim³

et al. 2014

Intervirology

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Objectives: This study investigated the antiviral efficacy of adefovir (ADV) rescue therapy and the feasibility of lamivudine (LAM) discontinuation in LAM-resistant chronic hepatitis B (CH-B) patients who had attained a virological response (VR) with LAM + ADV combination therapy. Methods: The VR and virological breakthrough (VBT) were analyzed in 106 consecutively enrolled LAM-resistant CH-B patients who received ADV rescue therapy during a mean follow-up period of 55.2 months. Seventy-four patients achieved VR, and were divided into the LAM-discontinuation group (n = 39) and the LAM-continuation group (n = 35). The VR and VBT between the 2 groups were compared. Results: For all 106 LAM-resistant CH-B patients, the overall cumulative probabilities of VR at 1, 2, 3 and 5 years of ADV rescue therapy were 40.6, 55.7, 64.6 and 81.3%, respectively. The cumulative probabilities of VBT at 1, 2, 3 and 5 years were 0, 2.9, 8.8 and 13.9%, respectively. Whether they discontinued or continued LAM after achieving VR on LAM + ADV therapy, VR and VBT were not significantly different during a mean follow-up period of 40.4 months. Conclusions: There was a good long-term VR with ADV rescue therapy for LAM-resistant CH-B patients. Moreover, discontinuing LAM was found to be feasible for patients who attained VR during ADV + LAM therapy.

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“…Genotypic resistance was analyzed in some patients with suspected LMV-R CHB and performed using the restriction fragment mass polymorphism method (Green Cross Reference Lab., Yongin, Korea) as previously described. 11 …”

Section: Methodsmentioning

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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Virologic Response at 12 Months of Treatment Predicts Sustained Antiviral Efficacy in Patients with Adefovir-Treated Lamivudine-Resistant Chronic Hepatitis B

Cited by 3 publications

References 30 publications

Variables determining the virologic response to adefovir treatment in patients with chronic HBV infection previously treated with lamivudine

Variables determining the virologic response to adefovir treatment in patients with chronic HBV infection previously treated with lamivudine

The Feasibility of Discontinuing Lamivudine in Lamivudine-Resistant Chronic Hepatitis B Patients on Lamivudine and Adefovir Combination Therapy

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

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