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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

TitleRandomized trial of lamivudine versus entecavir in entecavir-treated patients with undetectable hepatitis B virus DNA: Outcome at 2 Years
Authors
Issue Date2011
PublisherJohn 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?
AbstractWe 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 Identifierhttp://hdl.handle.net/10722/137377
ISSN
2015 Impact Factor: 11.711
2015 SCImago Journal Rankings: 4.752
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFung, Jen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorYuen, Jen_HK
dc.contributor.authorCheng, Cen_HK
dc.contributor.authorWu, Ren_HK
dc.contributor.authorKaHo Wong, Den_HK
dc.contributor.authorSeto, WKen_HK
dc.contributor.authorHung, IFNen_HK
dc.contributor.authorYuen, MFen_HK
dc.date.accessioned2011-08-26T14:24:08Z-
dc.date.available2011-08-26T14:24:08Z-
dc.date.issued2011en_HK
dc.identifier.citationHepatology, 2011, v. 53 n. 4, p. 1148-1153en_HK
dc.identifier.issn0270-9139en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137377-
dc.description.abstractWe 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.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/en_HK
dc.relation.ispartofHepatologyen_HK
dc.rightsHepatology. Copyright © John Wiley & Sons, Inc.-
dc.rightsSpecial 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.meshAlanine Transaminase - blood-
dc.subject.meshDNA, Viral - analysis-
dc.subject.meshGuanine - analogs and derivatives - therapeutic use-
dc.subject.meshHepatitis B, Chronic - drug therapy - virology-
dc.subject.meshLamivudine - adverse effects - therapeutic use-
dc.titleRandomized trial of lamivudine versus entecavir in entecavir-treated patients with undetectable hepatitis B virus DNA: Outcome at 2 Yearsen_HK
dc.typeArticleen_HK
dc.identifier.emailFung, J: jfung@sicklehut.comen_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailKaHo Wong, D: danywong@hku.hken_HK
dc.identifier.emailSeto, WK: wkseto2@hku.hken_HK
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailYuen, MF: mfyuen@hku.hken_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityKaHo Wong, D=rp00492en_HK
dc.identifier.authoritySeto, WK=rp01659en_HK
dc.identifier.authorityHung, IFN=rp00508en_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/hep.24192en_HK
dc.identifier.pmid21480321-
dc.identifier.scopuseid_2-s2.0-79953759250en_HK
dc.identifier.hkuros189830en_US
dc.identifier.hkuros213686-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79953759250&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume53en_HK
dc.identifier.issue4en_HK
dc.identifier.spage1148en_HK
dc.identifier.epage1153en_HK
dc.identifier.isiWOS:000289419600010-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridYuen, J=7102620480en_HK
dc.identifier.scopusauthoridCheng, C=24802108600en_HK
dc.identifier.scopusauthoridWu, R=37666418000en_HK
dc.identifier.scopusauthoridKaHo Wong, D=7401535819en_HK
dc.identifier.scopusauthoridSeto, WK=23390675900en_HK
dc.identifier.scopusauthoridHung, IFN=7006103457en_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK

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