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- Scopus: eid_2-s2.0-84870497833
- PMID: 22951420
- WOS: WOS:000311240000006
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Article: Outcome of lamivudine-resistant chronic hepatitis B after up to 5 years of combination therapy with adefovir
Title | Outcome of lamivudine-resistant chronic hepatitis B after up to 5 years of combination therapy with adefovir |
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Authors | |
Keywords | Adefovir Alanine aminotransferase Hepatitis B surface antigen Hepatitis B(e) antigen Lamivudine Virus DNA |
Issue Date | 2012 |
Publisher | International 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? |
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 (<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 Identifier | http://hdl.handle.net/10722/164363 |
ISSN | 2021 Impact Factor: 1.679 2020 SCImago Journal Rankings: 0.747 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Seto, WK | en_US |
dc.contributor.author | Liu, K | en_US |
dc.contributor.author | Fung, J | en_US |
dc.contributor.author | Wong, DKH | en_US |
dc.contributor.author | Yuen, JCH | en_US |
dc.contributor.author | Hung, IFN | en_US |
dc.contributor.author | Lai, CL | en_US |
dc.contributor.author | Yuen, MF | en_US |
dc.date.accessioned | 2012-09-20T07:58:11Z | - |
dc.date.available | 2012-09-20T07:58:11Z | - |
dc.date.issued | 2012 | en_US |
dc.identifier.citation | Antiviral Therapy, 2012, v. 17 n. 7, p. 1255-1262 | en_US |
dc.identifier.issn | 1359-6535 | - |
dc.identifier.uri | http://hdl.handle.net/10722/164363 | - |
dc.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 (<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.language | eng | en_US |
dc.publisher | International Medical Press. The Journal's web site is located at http://www.intmedpress.com/Journals/AVT/journals_avt_home.cfm | - |
dc.relation.ispartof | Antiviral Therapy | en_US |
dc.subject | Adefovir | - |
dc.subject | Alanine aminotransferase | - |
dc.subject | Hepatitis B surface antigen | - |
dc.subject | Hepatitis B(e) antigen | - |
dc.subject | Lamivudine | - |
dc.subject | Virus DNA | - |
dc.title | Outcome of lamivudine-resistant chronic hepatitis B after up to 5 years of combination therapy with adefovir | en_US |
dc.type | Article | en_US |
dc.identifier.email | Seto, WK: wkseto2@hku.hk | en_US |
dc.identifier.email | Fung, J: jfung@hkucc.hku.hk | en_US |
dc.identifier.email | Wong, DKH: danywong@hku.hk | en_US |
dc.identifier.email | Yuen, JCH: jchyuen@hkucc.hku.hk | en_US |
dc.identifier.email | Hung, IFN: ivanhung@hku.hk | en_US |
dc.identifier.email | Lai, CL: hrmelcl@hku.hk | en_US |
dc.identifier.email | Yuen, MF: mfyuen@hku.hk | en_US |
dc.identifier.authority | Seto, WK=rp01659 | en_US |
dc.identifier.authority | Fung, J=rp00518 | en_US |
dc.identifier.authority | Wong, DKH=rp00492 | en_US |
dc.identifier.authority | Hung, IFN=rp00508 | en_US |
dc.identifier.authority | Lai, CL=rp00314 | en_US |
dc.identifier.authority | Yuen, MF=rp00479 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.3851/IMP2335 | - |
dc.identifier.pmid | 22951420 | - |
dc.identifier.scopus | eid_2-s2.0-84870497833 | - |
dc.identifier.hkuros | 210472 | en_US |
dc.identifier.volume | 17 | - |
dc.identifier.issue | 7 | - |
dc.identifier.spage | 1255 | - |
dc.identifier.epage | 1262 | - |
dc.identifier.isi | WOS:000311240000006 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 1359-6535 | - |