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Article: Outcome of lamivudine-resistant chronic hepatitis B after up to 5 years of combination therapy with adefovir
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TitleOutcome of lamivudine-resistant chronic hepatitis B after up to 5 years of combination therapy with adefovir
 
AuthorsSeto, WK1
Liu, K1
Fung, J1
Wong, DKH1
Yuen, JCH1
Hung, IFN1
Lai, CL1 1
Yuen, MF1 1
 
KeywordsAdefovir
Alanine aminotransferase
Hepatitis B surface antigen
Hepatitis B(e) antigen
Lamivudine
Virus DNA
 
Issue Date2012
 
PublisherInternational Medical Press. The Journal's web site is located at http://www.intmedpress.com/Journals/AVT/journals_avt_home.cfm
 
CitationAntiviral Therapy, 2012, v. 17 n. 7, p. 1255-1262 [How to Cite?]
DOI: http://dx.doi.org/10.3851/IMP2335
 
AbstractBACKGROUND: There is a paucity of data on the long-term efficacy of combination lamivudine and adefovir therapy in patients with lamivudine-resistant chronic hepatitis B. METHODS: We determined the cumulative virological, serological and biochemical outcomes of 165 lamivudine-resistant chronic hepatitis B patients on lamivudine and adefovir for up to 5 years. Resistance profiles using a line probe assay were determined among patients with detectable viraemia. The significance of different baseline and on-treatment virological parameters was analysed. RESULTS: The median age and duration of follow-up were 45.1 years and 37.1 months, respectively. The cumulative rates of HBV DNA undetectability (<20 IU/ml), alanine aminotransferase normalization and hepatitis B e antigen seroconversion up to 5 years were 74.0%, 95.1% and 44.4%, respectively. One patient achieved hepatitis B surface antigen seroclearance. The 5-year cumulative resistance rate to adefovir was 10.2%. Among different baseline and on-treatment virological parameters, week 24 HBV DNA<200 IU/ml was associated with an increased chance of long-term virological suppression (P<0.001, OR 13.89, 95% CI 3.90, 49.46). Primary non-response and high baseline viral titres were not useful in predicting long-term virological outcomes. The 5-year cumulative rate of serum creatinine elevation >0.5 mg/dl was 4.1%. CONCLUSIONS: Combination lamivudine and adefovir therapy for up to 5 years achieved modest rates of virological suppression, but resistance developed in only 10.2% of patients. Week 24 HBV DNA<200 IU/ml was predictive of favourable long-term virological outcomes and could be used to assist treatment decisions on continuing lamivudine and adefovir or switching to more potent therapy. ©2012 International Medical Press.
 
ISSN1359-6535
2012 Impact Factor: 3.073
2012 SCImago Journal Rankings: 1.073
 
DOIhttp://dx.doi.org/10.3851/IMP2335
 
DC FieldValue
dc.contributor.authorSeto, WK
 
dc.contributor.authorLiu, K
 
dc.contributor.authorFung, J
 
dc.contributor.authorWong, DKH
 
dc.contributor.authorYuen, JCH
 
dc.contributor.authorHung, IFN
 
dc.contributor.authorLai, CL
 
dc.contributor.authorYuen, MF
 
dc.date.accessioned2012-09-20T07:58:11Z
 
dc.date.available2012-09-20T07:58:11Z
 
dc.date.issued2012
 
dc.description.abstractBACKGROUND: There is a paucity of data on the long-term efficacy of combination lamivudine and adefovir therapy in patients with lamivudine-resistant chronic hepatitis B. METHODS: We determined the cumulative virological, serological and biochemical outcomes of 165 lamivudine-resistant chronic hepatitis B patients on lamivudine and adefovir for up to 5 years. Resistance profiles using a line probe assay were determined among patients with detectable viraemia. The significance of different baseline and on-treatment virological parameters was analysed. RESULTS: The median age and duration of follow-up were 45.1 years and 37.1 months, respectively. The cumulative rates of HBV DNA undetectability (<20 IU/ml), alanine aminotransferase normalization and hepatitis B e antigen seroconversion up to 5 years were 74.0%, 95.1% and 44.4%, respectively. One patient achieved hepatitis B surface antigen seroclearance. The 5-year cumulative resistance rate to adefovir was 10.2%. Among different baseline and on-treatment virological parameters, week 24 HBV DNA<200 IU/ml was associated with an increased chance of long-term virological suppression (P<0.001, OR 13.89, 95% CI 3.90, 49.46). Primary non-response and high baseline viral titres were not useful in predicting long-term virological outcomes. The 5-year cumulative rate of serum creatinine elevation >0.5 mg/dl was 4.1%. CONCLUSIONS: Combination lamivudine and adefovir therapy for up to 5 years achieved modest rates of virological suppression, but resistance developed in only 10.2% of patients. Week 24 HBV DNA<200 IU/ml was predictive of favourable long-term virological outcomes and could be used to assist treatment decisions on continuing lamivudine and adefovir or switching to more potent therapy. ©2012 International Medical Press.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationAntiviral Therapy, 2012, v. 17 n. 7, p. 1255-1262 [How to Cite?]
DOI: http://dx.doi.org/10.3851/IMP2335
 
dc.identifier.doihttp://dx.doi.org/10.3851/IMP2335
 
dc.identifier.epage1262
 
dc.identifier.hkuros210472
 
dc.identifier.issn1359-6535
2012 Impact Factor: 3.073
2012 SCImago Journal Rankings: 1.073
 
dc.identifier.issue7
 
dc.identifier.pmid22951420
 
dc.identifier.scopuseid_2-s2.0-84870497833
 
dc.identifier.spage1255
 
dc.identifier.urihttp://hdl.handle.net/10722/164363
 
dc.identifier.volume17
 
dc.languageeng
 
dc.publisherInternational Medical Press. The Journal's web site is located at http://www.intmedpress.com/Journals/AVT/journals_avt_home.cfm
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofAntiviral Therapy
 
dc.subjectAdefovir
 
dc.subjectAlanine aminotransferase
 
dc.subjectHepatitis B surface antigen
 
dc.subjectHepatitis B(e) antigen
 
dc.subjectLamivudine
 
dc.subjectVirus DNA
 
dc.titleOutcome of lamivudine-resistant chronic hepatitis B after up to 5 years of combination therapy with adefovir
 
dc.typeArticle
 
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<item><contributor.author>Seto, WK</contributor.author>
<contributor.author>Liu, K</contributor.author>
<contributor.author>Fung, J</contributor.author>
<contributor.author>Wong, DKH</contributor.author>
<contributor.author>Yuen, JCH</contributor.author>
<contributor.author>Hung, IFN</contributor.author>
<contributor.author>Lai, CL</contributor.author>
<contributor.author>Yuen, MF</contributor.author>
<date.accessioned>2012-09-20T07:58:11Z</date.accessioned>
<date.available>2012-09-20T07:58:11Z</date.available>
<date.issued>2012</date.issued>
<identifier.citation>Antiviral Therapy, 2012, v. 17 n. 7, p. 1255-1262</identifier.citation>
<identifier.issn>1359-6535</identifier.issn>
<identifier.uri>http://hdl.handle.net/10722/164363</identifier.uri>
<description.abstract>BACKGROUND: There is a paucity of data on the long-term efficacy of combination lamivudine and adefovir therapy in patients with lamivudine-resistant chronic hepatitis B. METHODS: We determined the cumulative virological, serological and biochemical outcomes of 165 lamivudine-resistant chronic hepatitis B patients on lamivudine and adefovir for up to 5 years. Resistance profiles using a line probe assay were determined among patients with detectable viraemia. The significance of different baseline and on-treatment virological parameters was analysed. RESULTS: The median age and duration of follow-up were 45.1 years and 37.1 months, respectively. The cumulative rates of HBV DNA undetectability (&lt;20 IU/ml), alanine aminotransferase normalization and hepatitis B e antigen seroconversion up to 5 years were 74.0%, 95.1% and 44.4%, respectively. One patient achieved hepatitis B surface antigen seroclearance. The 5-year cumulative resistance rate to adefovir was 10.2%. Among different baseline and on-treatment virological parameters, week 24 HBV DNA&lt;200 IU/ml was associated with an increased chance of long-term virological suppression (P&lt;0.001, OR 13.89, 95% CI 3.90, 49.46). Primary non-response and high baseline viral titres were not useful in predicting long-term virological outcomes. The 5-year cumulative rate of serum creatinine elevation &gt;0.5 mg/dl was 4.1%. CONCLUSIONS: Combination lamivudine and adefovir therapy for up to 5 years achieved modest rates of virological suppression, but resistance developed in only 10.2% of patients. Week 24 HBV DNA&lt;200 IU/ml was predictive of favourable long-term virological outcomes and could be used to assist treatment decisions on continuing lamivudine and adefovir or switching to more potent therapy. &#169;2012 International Medical Press.</description.abstract>
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<relation.ispartof>Antiviral Therapy</relation.ispartof>
<subject>Adefovir</subject>
<subject>Alanine aminotransferase</subject>
<subject>Hepatitis B surface antigen</subject>
<subject>Hepatitis B(e) antigen</subject>
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<subject>Virus DNA</subject>
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Author Affiliations
  1. The University of Hong Kong