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Article: Randomized trial of lamivudine versus entecavir in entecavir-treated patients with undetectable hepatitis B virus DNA: Outcome at 2 Years
Title | Randomized trial of lamivudine versus entecavir in entecavir-treated patients with undetectable hepatitis B virus DNA: Outcome at 2 Years |
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Authors | |
Issue Date | 2011 |
Publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/ |
Citation | Hepatology, 2011, v. 53 n. 4, p. 1148-1153 How to Cite? |
Abstract | We aimed to determine the 2-year outcomes of entecavir followed by lamivudine in patients with undetectable viral load (<12 IU/mL) and normal alanine aminotransferase (ALT) after initial entecavir treatment for at least 6 months. Patients were randomly assigned 1:1 to continue with entecavir or switch to lamivudine. Liver biochemistry and hepatitis B virus (HBV) DNA were determined at weeks 0, 4, 12, 24, 48, 72, and 96. Mutational analysis using line-probe assay were performed at weeks 0, 24, 48, and 96 and at the time of HBV DNA relapse. There was no elevation of ALT observed in any patients up to 96 weeks. At 96 weeks of follow-up, 19/25 (76%) patients in the lamivudine arm had persistently undetectable HBV DNA, compared with 25/25 (100%) patients in the entecavir arm. Six patients in the lamivudine arm had HBV DNA >20 IU/mL, occurring at a range of 12 to 96 weeks. Of these, four patients had HBV DNA of less than 100 IU/mL during rebound (three had undetectable HBV DNA after switching back to entecavir), and the remaining two patients had HBV DNA levels of 7,973 and 699 IU/mL. Three patients (12%) had evidence of drug-resistant mutations, of which two patients had rtM204I mutation and one patient had rtM204V mutation. One of these three patients had previous lamivudine exposure before entecavir treatment and one patient had questionable drug compliance. Conclusion: Sequential therapy using entecavir followed by lamivudine resulted in virological rebound in 24% of patients after 96 weeks. Prior optimal viral suppression with entecavir did not confer any significant advantage in patients who switched to lamivudine. © 2011 American Association for the Study of Liver Diseases. |
Persistent Identifier | http://hdl.handle.net/10722/137377 |
ISSN | 2023 Impact Factor: 12.9 2023 SCImago Journal Rankings: 5.011 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
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dc.contributor.author | Fung, J | en_HK |
dc.contributor.author | Lai, CL | en_HK |
dc.contributor.author | Yuen, J | en_HK |
dc.contributor.author | Cheng, C | en_HK |
dc.contributor.author | Wu, R | en_HK |
dc.contributor.author | KaHo Wong, D | en_HK |
dc.contributor.author | Seto, WK | en_HK |
dc.contributor.author | Hung, IFN | en_HK |
dc.contributor.author | Yuen, MF | en_HK |
dc.date.accessioned | 2011-08-26T14:24:08Z | - |
dc.date.available | 2011-08-26T14:24:08Z | - |
dc.date.issued | 2011 | en_HK |
dc.identifier.citation | Hepatology, 2011, v. 53 n. 4, p. 1148-1153 | en_HK |
dc.identifier.issn | 0270-9139 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/137377 | - |
dc.description.abstract | We aimed to determine the 2-year outcomes of entecavir followed by lamivudine in patients with undetectable viral load (<12 IU/mL) and normal alanine aminotransferase (ALT) after initial entecavir treatment for at least 6 months. Patients were randomly assigned 1:1 to continue with entecavir or switch to lamivudine. Liver biochemistry and hepatitis B virus (HBV) DNA were determined at weeks 0, 4, 12, 24, 48, 72, and 96. Mutational analysis using line-probe assay were performed at weeks 0, 24, 48, and 96 and at the time of HBV DNA relapse. There was no elevation of ALT observed in any patients up to 96 weeks. At 96 weeks of follow-up, 19/25 (76%) patients in the lamivudine arm had persistently undetectable HBV DNA, compared with 25/25 (100%) patients in the entecavir arm. Six patients in the lamivudine arm had HBV DNA >20 IU/mL, occurring at a range of 12 to 96 weeks. Of these, four patients had HBV DNA of less than 100 IU/mL during rebound (three had undetectable HBV DNA after switching back to entecavir), and the remaining two patients had HBV DNA levels of 7,973 and 699 IU/mL. Three patients (12%) had evidence of drug-resistant mutations, of which two patients had rtM204I mutation and one patient had rtM204V mutation. One of these three patients had previous lamivudine exposure before entecavir treatment and one patient had questionable drug compliance. Conclusion: Sequential therapy using entecavir followed by lamivudine resulted in virological rebound in 24% of patients after 96 weeks. Prior optimal viral suppression with entecavir did not confer any significant advantage in patients who switched to lamivudine. © 2011 American Association for the Study of Liver Diseases. | en_HK |
dc.language | eng | en_US |
dc.publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/ | en_HK |
dc.relation.ispartof | Hepatology | en_HK |
dc.rights | Hepatology. Copyright © John Wiley & Sons, Inc. | - |
dc.rights | Special Statement for Preprint only Before publication: 'This is a preprint of an article accepted for publication in [The Journal of Pathology] Copyright © ([year]) ([Pathological Society of Great Britain and Ireland])'. After publication: the preprint notice should be amended to follows: 'This is a preprint of an article published in [include the complete citation information for the final version of the Contribution as published in the print edition of the Journal]' For Cochrane Library/ Cochrane Database of Systematic Reviews, add statement & acknowledgement : ‘This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 20XX, Issue X. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.’ Please include reference to the Review and hyperlink to the original version using the following format e.g. Authors. Title of Review. Cochrane Database of Systematic Reviews 20XX, Issue #. Art. No.: CD00XXXX. DOI: 10.1002/14651858.CD00XXXX (insert persistent link to the article by using the URL: http://dx.doi.org/10.1002/14651858.CD00XXXX) (This statement should refer to the most recent issue of the Cochrane Database of Systematic Reviews in which the Review published.) | - |
dc.subject.mesh | Alanine Transaminase - blood | - |
dc.subject.mesh | DNA, Viral - analysis | - |
dc.subject.mesh | Guanine - analogs and derivatives - therapeutic use | - |
dc.subject.mesh | Hepatitis B, Chronic - drug therapy - virology | - |
dc.subject.mesh | Lamivudine - adverse effects - therapeutic use | - |
dc.title | Randomized trial of lamivudine versus entecavir in entecavir-treated patients with undetectable hepatitis B virus DNA: Outcome at 2 Years | en_HK |
dc.type | Article | en_HK |
dc.identifier.email | Fung, J: jfung@sicklehut.com | en_HK |
dc.identifier.email | Lai, CL: hrmelcl@hku.hk | en_HK |
dc.identifier.email | KaHo Wong, D: danywong@hku.hk | en_HK |
dc.identifier.email | Seto, WK: wkseto2@hku.hk | en_HK |
dc.identifier.email | Hung, IFN: ivanhung@hkucc.hku.hk | en_HK |
dc.identifier.email | Yuen, MF: mfyuen@hku.hk | en_HK |
dc.identifier.authority | Fung, J=rp00518 | en_HK |
dc.identifier.authority | Lai, CL=rp00314 | en_HK |
dc.identifier.authority | KaHo Wong, D=rp00492 | en_HK |
dc.identifier.authority | Seto, WK=rp01659 | en_HK |
dc.identifier.authority | Hung, IFN=rp00508 | en_HK |
dc.identifier.authority | Yuen, MF=rp00479 | en_HK |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1002/hep.24192 | en_HK |
dc.identifier.pmid | 21480321 | - |
dc.identifier.scopus | eid_2-s2.0-79953759250 | en_HK |
dc.identifier.hkuros | 189830 | en_US |
dc.identifier.hkuros | 213686 | - |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-79953759250&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 53 | en_HK |
dc.identifier.issue | 4 | en_HK |
dc.identifier.spage | 1148 | en_HK |
dc.identifier.epage | 1153 | en_HK |
dc.identifier.isi | WOS:000289419600010 | - |
dc.publisher.place | United States | en_HK |
dc.identifier.scopusauthorid | Fung, J=23091109300 | en_HK |
dc.identifier.scopusauthorid | Lai, CL=7403086396 | en_HK |
dc.identifier.scopusauthorid | Yuen, J=7102620480 | en_HK |
dc.identifier.scopusauthorid | Cheng, C=24802108600 | en_HK |
dc.identifier.scopusauthorid | Wu, R=37666418000 | en_HK |
dc.identifier.scopusauthorid | KaHo Wong, D=7401535819 | en_HK |
dc.identifier.scopusauthorid | Seto, WK=23390675900 | en_HK |
dc.identifier.scopusauthorid | Hung, IFN=7006103457 | en_HK |
dc.identifier.scopusauthorid | Yuen, MF=7102031955 | en_HK |
dc.identifier.issnl | 0270-9139 | - |