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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Lamivudine
Chronic Hepatitis B
Hepatitis B virus
DNA
Hepatitis B e Antigens
ROC Curve
Therapeutics
adefovir
Alanine Transaminase
Multivariate Analysis
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

@article{ce13c04b3ed7413786f38a1c7e58c24c,
title = "Outcome of adefovir add-on lamivudine rescue therapy of up to 5years in patients with lamivudine-resistant chronic hepatitis B",
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.",
author = "Kim, {Sung Bae} and Seungup Kim and Kim, {Beom Kyung} and Junyong Park and doyoung kim and SangHoon Ahn and KwangHyub Han",
year = "2016",
month = "1",
day = "1",
doi = "10.1111/jgh.13046",
language = "English",
volume = "31",
pages = "241--247",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
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TY - JOUR

T1 - Outcome of adefovir add-on lamivudine rescue therapy of up to 5years in patients with lamivudine-resistant chronic hepatitis B

AU - Kim, Sung Bae

AU - Kim, Seungup

AU - Kim, Beom Kyung

AU - Park, Junyong

AU - kim, doyoung

AU - Ahn, SangHoon

AU - Han, KwangHyub

PY - 2016/1/1

Y1 - 2016/1/1

N2 - 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.

AB - 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.

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DO - 10.1111/jgh.13046

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JO - Journal of Gastroenterology and Hepatology (Australia)

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