Clin Mol Hepatol.  2013 Sep;19(3):273-279. 10.3350/cmh.2013.19.3.273.

Lamivudine plus adefovir combination therapy for lamivudine resistance in hepatitis-B-related hepatocellular carcinoma patients

• Kim JH
• Ko SY
• Choe WH
• Kwon SY
• Lee CH

• KMID: 1705205
• DOI: http://doi.org/10.3350/cmh.2013.19.3.273

Abstract

BACKGROUND/AIMS
Lamivudine (LAM) plus adefovir (ADV) combination therapy has been accepted as one of the best treatments for LAM-resistant chronic hepatitis B (CHB). The aim of this study was to determine the efficacy of this combination therapy in hepatocellular carcinoma (HCC) patients.
METHODS
The medical records of CHB patients who developed LAM resistance and were treated with LAM plus ADV combination therapy for more than 6 months were reviewed. Their virological response (VR; undetectable HBV DNA) and biochemical response (BR; alanine aminotransferase normalization) were evaluated, and the findings of HCC and non-HCC patients were compared.
RESULTS
The data from 104 patients (19 with HCC and 85 without HCC) were analyzed. The VR rates did not differ significantly between the HCC and non-HCC groups: 33.3% vs. 55.6% at 12 months (P=0.119), 58.3% vs. 67.2% at 24 months (P=0.742), 50% vs. 69.8% at 36 months (P=0.280), and 66.7% vs. 71.0% at 48 months (P=1.000). The BR rates also did not differ significantly between the groups: 55.6% vs. 84.0% at 12 months (P=0.021), 58.3% vs. 83.8% at 24 months (P=0.057), 70.0% vs. 77.8% at 36 months (P=0.687), and 66.7% vs. 80.6% at 48 months (P=0.591).
CONCLUSIONS
The efficacy of LAM plus ADV combination therapy is comparable in HCC and non-HCC patients.

Keyword

Chronic hepatitis B; Lamivudine; Adefovir; Resistance; Hepatocellular carcinoma

MeSH Terms

Adenine/*analogs & derivatives/therapeutic use
Adult
Antiviral Agents/*therapeutic use
Carcinoma, Hepatocellular/*diagnosis/epidemiology/etiology
DNA, Viral/analysis
Drug Administration Schedule
Drug Resistance, Viral
Drug Therapy, Combination
Genotype
Hepatitis B virus/genetics
Hepatitis B, Chronic/*drug therapy/virology
Humans
Incidence
Lamivudine/*therapeutic use
Liver Cirrhosis/diagnosis/epidemiology/etiology
Liver Neoplasms/*diagnosis/epidemiology/etiology
Middle Aged
Organophosphonates/*therapeutic use
Retrospective Studies
Treatment Outcome
Adenine
Antiviral Agents
DNA, Viral
Lamivudine
Organophosphonates