BACKGROUND: The incidence and risk factors for adefovir-resistant HBV have not been clearly defined. AIMS: To characterize the virologic response to adefovir, to determine the rate of adefovir resistance and to explore factors associated with initial virologic response (IVR) and adefovir resistance. METHODS: All hepatitis B patients who received adefovir for > or =6 months at our center were prospectively monitored for virologic response and adefovir resistance. RESULTS: Forty three patients were included; mean treatment duration was 18 months (range 6-45). Thirty four (79%) patients had prior lamivudine. IVR was observed in 44% patients and associated with higher pretreatment ALT (P = 0.05) and the absence of HBeAg (P = 0.02). Six (14%) patients were found to have adefovir-resistant mutations. The cumulative probability of genotypic resistance to adefovir at month 24 was 22%. Patients with adefovir resistance were more likely to have been switched from lamivudine to adefovir monotherapy (P = 0.01), to be older (P = 0.04), and to be infected with HBV genotype D (P = 0.02). CONCLUSIONS: Roughly 50% of patients failed to achieve IVR on adefovir. The cumulative probability of adefovir resistance at 2 years was 22%. Our data suggest that combination of lamivudine and adefovir may prevent emergence of adefovir resistance in patients with lamivudine-resistant HBV.
BACKGROUND: The incidence and risk factors for adefovir-resistant HBV have not been clearly defined. AIMS: To characterize the virologic response to adefovir, to determine the rate of adefovir resistance and to explore factors associated with initial virologic response (IVR) and adefovir resistance. METHODS: All hepatitis Bpatients who received adefovir for > or =6 months at our center were prospectively monitored for virologic response and adefovir resistance. RESULTS: Forty three patients were included; mean treatment duration was 18 months (range 6-45). Thirty four (79%) patients had prior lamivudine. IVR was observed in 44% patients and associated with higher pretreatment ALT (P = 0.05) and the absence of HBeAg (P = 0.02). Six (14%) patients were found to have adefovir-resistant mutations. The cumulative probability of genotypic resistance to adefovir at month 24 was 22%. Patients with adefovir resistance were more likely to have been switched from lamivudine to adefovir monotherapy (P = 0.01), to be older (P = 0.04), and to be infected with HBV genotype D (P = 0.02). CONCLUSIONS: Roughly 50% of patients failed to achieve IVR on adefovir. The cumulative probability of adefovir resistance at 2 years was 22%. Our data suggest that combination of lamivudine and adefovir may prevent emergence of adefovir resistance in patients with lamivudine-resistant HBV.
Authors: Eleftherios Michailidis; Karen A Kirby; Atsuko Hachiya; Wangdon Yoo; Sun Pyo Hong; Soo-Ok Kim; William R Folk; Stefan G Sarafianos Journal: Int J Biochem Cell Biol Date: 2012-04-16 Impact factor: 5.085
Authors: Tae Jung Yun; Jin Yong Jung; Chang Ha Kim; Soon Ho Um; Hyonggin An; Yeon Seok Seo; Jin Dong Kim; Hyung Joon Yim; Bora Keum; Yong Sik Kim; Yoon Tae Jeen; Hong Sik Lee; Hoon Jai Chun; Chang Duck Kim; Ho Sang Ryu Journal: World J Gastroenterol Date: 2012-12-21 Impact factor: 5.742
Authors: Jung Woo Shin; Neung Hwa Park; Seok Won Jung; Byung Chul Kim; Sung Ho Kwon; Jae Serk Park; In Du Jeong; Sung-Jo Bang; Do Ha Kim Journal: World J Gastroenterol Date: 2006-11-07 Impact factor: 5.742