| Autor: |
Vassiliadis, Themistoklis G., Giouleme, Olga, Koumerkeridis, Georgios, Koumaras, Haralabos, Tziomalos, Konstantinos, Patsiaoura, Kalliopi, Grammatikos, Nikolaos, Mpoumponaris, Alexandros, Gkisakis, Dimitrios, Theodoropoulos, Konstantinos, Panderi, Athanasia, Katsinelos, Panagiotis, Eugenidis, Nikolaos |
| Předmět: |
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| Zdroj: |
Journal of Gastroenterology & Hepatology; Jan2010, Vol. 25 Issue 1, p54-60, 7p, 2 Charts, 3 Graphs |
| Abstrakt: |
Background and Aim: Adefovir dipivoxil (ADV) is effective in lamivudine (LAM)-resistant hepatitis B e antigen-negative (HBeAg-) chronic hepatitis B (CHB). However, it is unclear whether LAM treatment should be continued in these patients. We aimed to compare the long-term efficacy of adding ADV to ongoing LAM treatment versus switching to ADV monotherapy in LAM-resistant HBeAg- CHB. Methods: Sixty LAM-resistant patients with HBeAg- CHB were randomly assigned (3:1) to combination therapy (10 mg ADV once daily plus ongoing LAM at 100 mg once daily [ n = 45]) or 10 mg ADV monotherapy once daily ( n = 15). Virological and biochemical responses were defined as hepatitis B virus (HBV)–DNA <400 copies/mL and as normalization of alanine aminotransferase levels, respectively. Results: The median follow-up time was 53 months (range 20–60 months). A virological response was observed in 38/45 (84.4%) and 11/15 (73.3%) patients in the ADV/LAM and ADV monotherapy groups, respectively ( P = 0.56). Biochemical response rates were higher in the ADV/LAM group than in the ADV monotherapy group (90.9% vs 57.1%, respectively; P = 0.01). In the ADV/LAM group, serum HBV–DNA remained undetectable in all patients who achieved a virological response ( n = 38). In the ADV monotherapy group, virological breakthrough occurred in four of the 11 patients who achieved a virological response (36.4%; P < 0.001 vs the ADV/LAM group, log–rank test). In addition, two patients in each group who did not achieve a virological response eventually developed ADV resistance. Conclusions: Adding ADV to LAM is more effective than switching to ADV monotherapy in LAM-resistant patients with HBeAg- CHB. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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