Clin Mol Hepatol.  2014 Sep;20(3):274-282. 10.3350/cmh.2014.20.3.274.

Hepatitis B surface antigen levels at 6 months after treatment can predict the efficacy of lamivudine-adefovir combination therapy in patients with lamivudine-resistant chronic hepatitis B

• Kim JH
• Moon HW
• Ko SY
• Choe WH
• Kwon SY

• KMID: 2069764
• DOI: http://doi.org/10.3350/cmh.2014.20.3.274

Abstract

BACKGROUND/AIMS
Quantitation of hepatitis B surface antigen (HBsAg) is an increasingly popular method to determine the treatment response in chronic hepatitis B (CHB) patients. The clinical value of HBsAg level measurement during rescue therapy for lamivudine (LMV)-resistant CHB patients have not been evaluated to date. Therefore, this study investigated the correlation between HBsAg level and treatment response in LMV-resistant CHB patients treated with adefovir (ADV) add-on therapy.
METHODS
LMV-resistant CHB patients treated with LMV-ADV combination therapy for over 2 years were included. HBsAg levels were measured at 6 month intervals until 1 year, and annually thereafter. Treatment response was assessed by determining the virological response (VR, undetectable HBV DNA levels) during treatment.
RESULTS
Fifty patients were included, of which 40 showed a VR. HBsAg levels were not different significantly at baseline (4.0 vs. 3.6 Log10 IU/mL, P=0.072). However, the HBsAg level decreased after 6 months of treatment in patients with a VR and became different significantly between the groups thereafter (3.9 vs. 3.3 at 6 months, P=0.002; 3.8 vs. 3.2 at 1 year, P=0.004; 3.9 vs. 3.2 at 2 years, P=0.008; 3.7 vs. 3.1 at 3 years, P =0.020).
CONCLUSIONS
The HBsAg level at 6 months after treatment can help predict treatment response.

Keyword

Hepatitis B, Chronic; Hepatitis B surface antigen; Lamivudine; Adefovir; Resistance

MeSH Terms

Adenine/*therapeutic use
Adult
Antiviral Agents/*therapeutic use
Area Under Curve
DNA, Viral/blood
Drug Resistance, Viral
Female
Hepatitis B Surface Antigens/*blood
Hepatitis B virus/genetics
Hepatitis B, Chronic/*drug therapy/virology
Humans
Lamivudine/*therapeutic use
Male
Middle Aged
Organophosphates/*therapeutic use
ROC Curve
Treatment Outcome
Adenine
Antiviral Agents
DNA, Viral
Hepatitis B Surface Antigens
Organophosphates
Lamivudine