Korean J Hepatol.  2009 Mar;15(1):52-58. 10.3350/kjhep.2009.15.1.52.

Virologic response to adefovir dipivoxil monotherapy is not durable in HBeAg-positive, lamivudine-resistant chronic hepatitis B patients

• Jung HW
• Choi MS
• Kim KH
• Park SH
• Yeon KK
• Lee JH
• Koh KC
• Paik SW
• Yoo BC

• KMID: 1776814
• DOI: http://doi.org/10.3350/kjhep.2009.15.1.52

Abstract

BACKGROUNDS/AIMS
It has been shown that adefovir dipivoxil is an effective antiviral agent in the treatment of chronic hepatitis B (CHB), not only in wild-type hepatitis B virus (HBV) infection, but also in lamivudine-resistant (LAMV-R) cases. However, little is known about the durability of the virologic response to adefovir in LAMV-R CHB patients.
METHODS
Fifteen HBV e-antigen (HBeAg)-positive, LAMV-R CHB patients showed a virologic response to adefovir monotherapy. These patients received additional adefovir for at least a further 12 months. The virologic relapse rate after discontinuation of adefovir was evaluated. In addition, predictive factors associated with virologic relapse were investigated.
RESULTS
The median level of serum HBV DNA before adefovir administration was 7,457,840 IU/mL (range 107,920-99,524,960 IU/mL). The median duration of adefovir treatment was 30 months (range 14-46 months). During a median follow-up period of 14 months after discontinuation of adefovir, the 1-, 2-, 3-, 6-, and 12-month cumulative relapse rates were 26.7%, 53.3%, 73.3%, 80%, and 80%, respectively. High pretreatment HBV DNA levels were found to be the only factor that was predictive of off-therapy relapse.
CONCLUSIONS
Our data suggest that the adefovir-monotherapy-induced virologic response is not durable in most patients with LAMV-R HBeAg-positive CHB, especially in those with a high pretreatment HBV DNA level.

Keyword

Adefovir dipivoxil; Lamivudine; Drug Resistance, Viral; Durability

MeSH Terms

Adenine/*analogs & derivatives/therapeutic use
Adult
Aged
Antiviral Agents/*therapeutic use
DNA, Viral/analysis
Drug Resistance, Viral
Female
Hepatitis B e Antigens/*blood
Hepatitis B, Chronic/*drug therapy
Humans
Lamivudine/*therapeutic use
Male
Middle Aged
Phosphonic Acids/*therapeutic use
Recurrence
Retrospective Studies
Risk Factors