In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 30, No. 10 ( 2015-10), p. 1514-1521
Abstract:
In the past decade, many chronic hepatitis B ( CHB ) patients have undergone sequential treatment with lamivudine ( LAM ), adefovir ( ADV ), and entecavir ( ETV ) to manage antiviral resistance or insufficient suppression of HBV ‐ DNA . Very limited data are available on the efficacy of tenofovir ( TDF ) rescue regimens in patients with multidrug resistance ( MDR ). Methods We investigated the antiviral efficacy of TDF / LAM combination therapy versus TDF / ETV combination therapy in 52 patients who failed three previous antiviral therapies. Results The study subjects were treated with TDF / LAM combination therapy ( n = 25) or TDF / ETV combination therapy ( n = 27) for more than six months. Virologic response ( VR ) occurred in 39 (75%) patients (19 patients belonged to the TDF / LAM group and 20 patients belonged to the TDF / ETV group). The VR rates were not different between the TDF / LAM and TDF / ETV groups (56.0% vs 51.9% at month 12, and 72.0% vs 78.8% at month 18; log rank P = 0.515). In addition, treatment efficacy of TDF / LAM combination or TDF / ETV combination was not statistically different according to types of MDR . In multivariate analysis, absolute HBV ‐ DNA level at the start of TDF rescue treatment ( P 〈 0.001; OR , 0.452; 95% CI , 0.306–0.666) was only significantly associated with VR . Conclusions TDF / ETV combination therapy was not associated with higher rate of VR compared with TDF / LAM combination therapy in MDR CHB patients. These results raise the suspicion about the superiority of the combination therapy over TDF monotherapy. The lower HBV ‐ DNA levels at the start of TDF ‐based rescue therapy were associated with higher VR .
Type of Medium:
Online Resource
ISSN:
0815-9319
,
1440-1746
DOI:
10.1111/jgh.2015.30.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2015
detail.hit.zdb_id:
2006782-3
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