Antiviral Drug Resistance Testing in Patients with Chronic Hepatitis B

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Source: Dig Dis Sci | Posted 4 days ago

Antiviral Drug Resistance Testing in Patients with Chronic Hepatitis B

Wong VW, Wong GL, Tse CH, Yuen LK, Chan HY, Locarnini SA, Chan HL;

Digestive Diseases and Sciences (Jul 2011)

BACKGROUND: Antiviral drugs against hepatitis B virus are limited by the

emergence of drug resistance. AIMS: We aimed to study the impact of drug

resistance testing on treatment decisions. METHODS: In part 1 of this study,

consecutive patients with chronic hepatitis B who had antiviral drug resistance

testing were studied. Part 2 was a two-step questionnaire survey including ten

characteristic case scenarios. Hepatologists were asked about their treatment

decisions before and after the knowledge of drug resistance results. RESULTS:

Fifty-one patients underwent drug resistance testing, most of whom were on

lamivudine, adefovir dipivoxil or entecavir monotherapy. Thirty-four (67%)

patients had drug-resistant mutants detected, 4 (8%) had low viral load, and 13

(25%) harboured wild-type virus. Twenty-nine of 34 (85%) patients harbouring

drug-resistant mutants and 9 of 17 (53%) patients with no mutants detected

changed their drug regimens (P = 0.038). In part 2, 18 hepatologists completed

all two questionnaires. Overall, treatment decision was modified in 52% of cases

upon receiving the drug resistance testing results. The detection of rtA181V/I

resulted in decision changes in most hepatologists, with the preferred treatment

switching from tenofovir to entecavir. When no mutants were detected in partial

responders to entecavir monotherapy, most hepatologists chose to increase the

dose of entecavir. CONCLUSIONS: Drug-resistant mutations are detected in around

two-thirds of chronic hepatitis B patients undergoing drug resistance testing.

Drug resistance testing alters management in over half of the cases, and should

be considered in all patients with virological breakthrough and suboptimal

virological suppression.

[Guest guest]

http://www.docguide.com/antiviral-drug-resistance-testing-patients-chronic-hepat\

itis-b?hash=04301bd4 & eid=21056 & alrhash=2e06a4-d460252966da8019c5213f6ae197892e

Source: Dig Dis Sci | Posted 4 days ago

Antiviral Drug Resistance Testing in Patients with Chronic Hepatitis B

Wong VW, Wong GL, Tse CH, Yuen LK, Chan HY, Locarnini SA, Chan HL;

Digestive Diseases and Sciences (Jul 2011)

BACKGROUND: Antiviral drugs against hepatitis B virus are limited by the

emergence of drug resistance. AIMS: We aimed to study the impact of drug

resistance testing on treatment decisions. METHODS: In part 1 of this study,

consecutive patients with chronic hepatitis B who had antiviral drug resistance

testing were studied. Part 2 was a two-step questionnaire survey including ten

characteristic case scenarios. Hepatologists were asked about their treatment

decisions before and after the knowledge of drug resistance results. RESULTS:

Fifty-one patients underwent drug resistance testing, most of whom were on

lamivudine, adefovir dipivoxil or entecavir monotherapy. Thirty-four (67%)

patients had drug-resistant mutants detected, 4 (8%) had low viral load, and 13

(25%) harboured wild-type virus. Twenty-nine of 34 (85%) patients harbouring

drug-resistant mutants and 9 of 17 (53%) patients with no mutants detected

changed their drug regimens (P = 0.038). In part 2, 18 hepatologists completed

all two questionnaires. Overall, treatment decision was modified in 52% of cases

upon receiving the drug resistance testing results. The detection of rtA181V/I

resulted in decision changes in most hepatologists, with the preferred treatment

switching from tenofovir to entecavir. When no mutants were detected in partial

responders to entecavir monotherapy, most hepatologists chose to increase the

dose of entecavir. CONCLUSIONS: Drug-resistant mutations are detected in around

two-thirds of chronic hepatitis B patients undergoing drug resistance testing.

Drug resistance testing alters management in over half of the cases, and should

be considered in all patients with virological breakthrough and suboptimal

virological suppression.