In:
Intervirology, S. Karger AG, Vol. 57, No. 5 ( 2014), p. 239-247
Abstract:
〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 This study was designed to prospectively evaluate the antiviral responses and evolution of resistance mutations during adefovir (ADV) plus lamivudine (LMV) therapy in patients with entecavir (ETV)-resistant hepatitis B virus (HBV) infection. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Twenty chronic hepatitis B (CHB) patients who had been receiving ETV for more than 6 months and developed virologic breakthrough due to ETV resistance were consecutively enrolled. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Patients received ADV plus LMV therapy for 12 months. The baseline mean serum HBV DNA level was 5.59 ± 1.28 log 〈 sub 〉 10 〈 /sub 〉 IU/ml. The rtT184L/I/A/F (50%), rtS202G (25%) and mixed ETV-resistant mutations (25%) were detected at enrollment. The mean reduction in serum HBV DNA levels from baseline to 12 months was -2.3 ± 1.06 log 〈 sub 〉 10 〈 /sub 〉 IU/ml (p 〈 i 〉 〈 〈 /i 〉 0.001). Seventeen patients were followed up for the full 12 months, and complete virologic response (HBV DNA 〈 20 IU/ml) was observed in 4 patients (23.5%). Among the remaining 13 patients who still had detectable HBV DNA, 7 patients showed disappearance of ETV-resistant mutations or reduction of the proportion of ETV-resistant mutants. An ADV- and LMV-resistant mutant (rtA181T) emerged in 2 patients (11.7%). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 ADV plus LMV combination therapy suppresses ETV-resistant mutants in the viral population and significantly reduces serum HBV DNA levels in ETV-resistant CHB patients.
Type of Medium:
Online Resource
ISSN:
0300-5526
,
1423-0100
Language:
English
Publisher:
S. Karger AG
Publication Date:
2014
detail.hit.zdb_id:
1482863-7
SSG:
12
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