Rescue monotherapy in lamivudine-resistant hepatitis B e antigen-positive chronic hepatitis B: Adefovir versus entecavir

Jung Min Lee, Hyung Joon Kim, Jun Yong Park, Chun Kyon Lee, Do Young Kim, Ja Kyung Kim, Hyun Woong Lee, Yong Han Paik, Kwan Sik Lee, Kwang Hyub Han, Chae Yoon Chon, Sun Pyo Hong, Tin Nguyen, Sang Hoon Ahn

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Abstract

Background: The efficacy of adefovir dipivoxil (ADV) or entecavir (ETV) rescue monotherapy has not been directly compared in hepatitis B e antigen (HBeAg)-positive patients with lamivudine (3TC)-resistant chronic hepatitis B (CHB). We compared the efficacy of ADV and ETV rescue monotherapy in HBeAg-positive patients with confirmed genotypic 3TC resistance. Methods: A total of 160 HBeAg-positive patients with confirmed 3TC resistance underwent switch therapy (91 ADV and 59 ETV). Parameters assessed included alanine aminotransferase (ALT) normalization, HBeAg seroconversion, undetectable serum hepatitis B virus (HBV) DNA by PCR (lower detection limit <300 copies/ml), virological breakthrough and initial virological response (IVR) at 3 (IVR-3) and 6 (IVR-6) months. Results: Following 52 weeks of treatment in the ADV and ETV groups, serum HBV DNA became undetectable in 25 (27.5%) and 21 (35.6%; P=0.292) patients, ALT normalization occurred in 67/78 (85.9%) and 43/47 (91.5%; P=0.351). HBeAg seroconversion in 4 (4.4%) and 1 (1.7%; P=1.000), IVR-3 in 19 (20.9%) and 18 (30.5%). IVR-6 in 40 (44.0%) and 25 (42.4%) and virological breakthrough in 2 (2.2%) and 1 (1.7%; P=1.000) patients, respectively. Conclusions: ADV and ETV revealed comparable efficacy after 52 weeks of treatment in HBeAg-positive patients with 3TC resistance. Undetectable HBV DNA in serum following 52 weeks of treatment was predictable with IVR-3 and IVR-6 in both groups.

Original languageEnglish
Pages (from-to)705-712
Number of pages8
JournalAntiviral therapy
Volume14
Issue number5
Publication statusPublished - 2009

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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    Lee, J. M., Kim, H. J., Park, J. Y., Lee, C. K., Kim, D. Y., Kim, J. K., Lee, H. W., Paik, Y. H., Lee, K. S., Han, K. H., Chon, C. Y., Hong, S. P., Nguyen, T., & Ahn, S. H. (2009). Rescue monotherapy in lamivudine-resistant hepatitis B e antigen-positive chronic hepatitis B: Adefovir versus entecavir. Antiviral therapy, 14(5), 705-712.