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Article: Outcome of lamivudine-resistant chronic hepatitis B after up to 5 years of combination therapy with adefovir

TitleOutcome of lamivudine-resistant chronic hepatitis B after up to 5 years of combination therapy with adefovir
Authors
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
Citation
Antiviral Therapy, 2012, v. 17 n. 7, p. 1255-1262 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/164363
ISSN
2014 Impact Factor: 3.020
2014 SCImago Journal Rankings: 1.340
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorSeto, WKen_US
dc.contributor.authorLiu, Ken_US
dc.contributor.authorFung, Jen_US
dc.contributor.authorWong, DKHen_US
dc.contributor.authorYuen, JCHen_US
dc.contributor.authorHung, IFNen_US
dc.contributor.authorLai, CLen_US
dc.contributor.authorYuen, MFen_US
dc.date.accessioned2012-09-20T07:58:11Z-
dc.date.available2012-09-20T07:58:11Z-
dc.date.issued2012en_US
dc.identifier.citationAntiviral Therapy, 2012, v. 17 n. 7, p. 1255-1262en_US
dc.identifier.issn1359-6535-
dc.identifier.urihttp://hdl.handle.net/10722/164363-
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.languageengen_US
dc.publisherInternational Medical Press. The Journal's web site is located at http://www.intmedpress.com/Journals/AVT/journals_avt_home.cfm-
dc.relation.ispartofAntiviral Therapyen_US
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 adefoviren_US
dc.typeArticleen_US
dc.identifier.emailSeto, WK: wkseto2@hku.hken_US
dc.identifier.emailFung, J: jfung@hkucc.hku.hken_US
dc.identifier.emailWong, DKH: danywong@hku.hken_US
dc.identifier.emailYuen, JCH: jchyuen@hkucc.hku.hken_US
dc.identifier.emailHung, IFN: ivanhung@hku.hken_US
dc.identifier.emailLai, CL: hrmelcl@hku.hken_US
dc.identifier.emailYuen, MF: mfyuen@hku.hken_US
dc.identifier.authoritySeto, WK=rp01659en_US
dc.identifier.authorityFung, J=rp00518en_US
dc.identifier.authorityWong, DKH=rp00492en_US
dc.identifier.authorityHung, IFN=rp00508en_US
dc.identifier.authorityLai, CL=rp00314en_US
dc.identifier.authorityYuen, MF=rp00479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.3851/IMP2335-
dc.identifier.pmid22951420-
dc.identifier.scopuseid_2-s2.0-84870497833-
dc.identifier.hkuros210472en_US
dc.identifier.volume17-
dc.identifier.issue7-
dc.identifier.spage1255-
dc.identifier.epage1262-
dc.identifier.isiWOS:000311240000006-
dc.publisher.placeUnited Kingdom-

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