Long-term efficacy of entecavir therapy in chronic hepatitis B patients with antiviral resistance to lamivudine and adefovir

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2011.01461.x/abstract

Long-term efficacy of entecavir therapy in chronic hepatitis B patients with

antiviral resistance to lamivudine and adefovir

M. S. Kwak1, J. W. Choi1, J. S. Lee2, K. A. Kim2, J. H. Suh1, Y. S. Cho1, S. Y.

Won1, B. K. Park1, C. K. Lee1

Article first published online: 13 MAY 2011

DOI: 10.1111/j.1365-2893.2011.01461.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Early View (Online Version of Record published before inclusion in an issue)

Summary.  No studies have reported the long-term effects of entecavir

switching in patients with multidrug resistance who developed resistance after

lamivudine/adefovir sequential therapy. We evaluated the efficacy of 96 weeks of

entecavir therapy in patients with resistance to lamivudine/adefovir sequential

therapy. In total, 33 patients with chronic hepatitis B virus (HBV) infection

with evidence of active viral replication (HBV DNA levels ≥105 copies/mL) or a

history of treatment failure to lamivudine/adefovir sequential therapy between

April 2007 and July 2009 were treated with entecavir (1.0 mg daily) for at least

48 weeks. The rates of alanine transaminase (ALT) normalization and HBV DNA

negativity were 66.7% (14/21) and 24.2% (8/33) at 48 weeks, respectively. The

initial HBV DNA level was the only factor that was inversely associated with

serum HBV DNA negativity after 48 weeks of entecavir therapy (P < 0.023). At 96

weeks, the rates of ALT normalization and HBV DNA negativity were 77.8% (7/9)

and 16.7% (3/18), respectively. Viral breakthrough occurred in 21.2% (7/33) and

78.9% (15/19) of patients at 48 and 96 weeks, respectively. Patients who

achieved a HBV DNA level of <4 log10 copies/mL at 48 weeks maintained a similar

HBV DNA level and a normal ALT level until 96 weeks. Entecavir monotherapy for

96 weeks was not efficacious for patients with lamivudine/adefovir-resistant

HBV. The initial HBV DNA level was the only predictive factor for antiviral

efficacy. However, patients who achieved a HBV DNA level of <4 log10 copies/mL

with a normal ALT level at 48 weeks should maintain, rather than stop, entecavir

therapy.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2011.01461.x/abstract

Long-term efficacy of entecavir therapy in chronic hepatitis B patients with

antiviral resistance to lamivudine and adefovir

M. S. Kwak1, J. W. Choi1, J. S. Lee2, K. A. Kim2, J. H. Suh1, Y. S. Cho1, S. Y.

Won1, B. K. Park1, C. K. Lee1

Article first published online: 13 MAY 2011

DOI: 10.1111/j.1365-2893.2011.01461.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Early View (Online Version of Record published before inclusion in an issue)

Summary.  No studies have reported the long-term effects of entecavir

switching in patients with multidrug resistance who developed resistance after

lamivudine/adefovir sequential therapy. We evaluated the efficacy of 96 weeks of

entecavir therapy in patients with resistance to lamivudine/adefovir sequential

therapy. In total, 33 patients with chronic hepatitis B virus (HBV) infection

with evidence of active viral replication (HBV DNA levels ≥105 copies/mL) or a

history of treatment failure to lamivudine/adefovir sequential therapy between

April 2007 and July 2009 were treated with entecavir (1.0 mg daily) for at least

48 weeks. The rates of alanine transaminase (ALT) normalization and HBV DNA

negativity were 66.7% (14/21) and 24.2% (8/33) at 48 weeks, respectively. The

initial HBV DNA level was the only factor that was inversely associated with

serum HBV DNA negativity after 48 weeks of entecavir therapy (P < 0.023). At 96

weeks, the rates of ALT normalization and HBV DNA negativity were 77.8% (7/9)

and 16.7% (3/18), respectively. Viral breakthrough occurred in 21.2% (7/33) and

78.9% (15/19) of patients at 48 and 96 weeks, respectively. Patients who

achieved a HBV DNA level of <4 log10 copies/mL at 48 weeks maintained a similar

HBV DNA level and a normal ALT level until 96 weeks. Entecavir monotherapy for

96 weeks was not efficacious for patients with lamivudine/adefovir-resistant

HBV. The initial HBV DNA level was the only predictive factor for antiviral

efficacy. However, patients who achieved a HBV DNA level of <4 log10 copies/mL

with a normal ALT level at 48 weeks should maintain, rather than stop, entecavir

therapy.