Outcome of adefovir add-on lamivudine rescue therapy of up to 5years in patients with lamivudine-resistant chronic hepatitis B

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Abstract

Background and Aim: We investigated the long-term efficacy of adefovir add-on lamivudine rescue therapy in lamivudine-resistant chronic hepatitis B and the optimal cutoff hepatitis B virus (HBV) DNA level that predicts complete virological response (CVR) among patients without CVR after 1year of treatment. Methods: We reviewed 167 lamivudine-resistant chronic hepatitis B patients who received adefovir add-on rescue therapy for up to 5years. Multivariate analysis, area under the receiver operating characteristic curves, and Youden index were used. Results: Median age was 47.0years; 112 patients were male. Median baseline HBV DNA level was 6.6log10IU/mL; hepatitis B e antigen was positive in 130 (77.4%) patients. Five-year CVR, alanine aminotransferase normalization, hepatitis B e antigen seroconversion, and adefovir resistance rates were 86.9%, 92.5%, 16.7%, and 6.0%, respectively. One-year HBV DNA level independently associated with CVR. Optimal cutoff HBV DNA level to predict CVR among patients who failed to achieve CVR at 1year was 800IU/mL (area under receiver operating characteristic curve 0.752; sensitivity 49.3%, specificity 93.5%). During the 5-year treatment, 92.1% of patients with favorable response (HBV DNA<800IU/mL at 1year) achieved CVR; 45.6% achieved CVR among suboptimal responders (HBV DNA≥800IU/mL at 1year) (P<0.001). Conclusion: Complete virological response or HBV DNA level<800IU/mL after 1year adefovir add-on lamivudine rescue therapy can favorably predict CVR.

Original languageEnglish
Pages (from-to)241-247
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume31
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

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All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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