Adefovir-based combination therapy with entecavir or lamivudine for patients with entecavir-refractory chronic hepatitis B
Version of Record online: 25 OCT 2011
Copyright © 2011 Wiley Periodicals, Inc.
Journal of Medical Virology
Volume 84, Issue 1, pages 18–25, January 2012
How to Cite
Kim, S. S., Cheong, J. Y., Lee, D., Lee, M. H., Hong, S. P., Kim, S.-O. and Cho, S. W. (2012), Adefovir-based combination therapy with entecavir or lamivudine for patients with entecavir-refractory chronic hepatitis B. J. Med. Virol., 84: 18–25. doi: 10.1002/jmv.22227
- Issue online: 15 NOV 2011
- Version of Record online: 25 OCT 2011
- Manuscript Accepted: 8 AUG 2011
- Korean Health 21 R & D Project, Ministry of Health and Welfare, Republic of Korea. Grant Number: A050021
- entecavir resistance;
- chronic hepatitis B;
This study evaluated the efficacy of adefovir (ADV) plus lamivudine (LAM) or ADV add-on therapy for patients with entecavir (ETV)-refractory hepatitis B infection. Twenty-nine ETV-resistant and 8 patients with suboptimal response to ETV were enrolled. Twenty-seven patients received ADV + LAM therapy and 10 patients received ADV + ETV therapy for >24 weeks. In 29 patients who were ETV-resistant, the mean reduction in HBV DNA levels at 24 weeks was not different between the ADV + LAM and ADV + ETV groups (−1.98 log10 IU/ml vs. −2.16 log10 IU/ml; P = 0.792). Primary non-response was observed in 52.2% (12/23) of ADV + LAM group and 33.3% (2/6) of ADV + ETV group (P = 0.651). Initial virologic response (IVR) was observed in 17.4% (4/23) of ADV + LAM group and 33.3% (2/6) of ETV + ADV group (P = 0.362). In eight patients with suboptimal response to ETV, the ADV + ETV group had a greater reduction in HBV DNA at 24 and 48 weeks than the ADV + LAM group (−2.29 log10 IU/ml vs. −0.09 log10 IU/ml and −2.04 log10 IU/ml vs. −0.72 log10 IU/ml; P = 0.020 and P = 0.012, respectively). Primary non-response and IVR did not significantly differ between the two groups [100% (4/4) vs. 50% (2/4) and 0% (0/4) vs. 50% (2/4); P = 0.429 and P = 0.429, respectively]. The antiviral efficacies of ADV-based therapy with ETV or LAM for patients with ETV-resistant hepatitis B were limited and did not differ between the two groups. However, adding ADV to ETV may be more effective than ADV + LAM therapy in patients with suboptimal virologic response to ETV. J. Med. Virol. 84:18–25, 2011. © 2011 Wiley Periodicals, Inc.