Korean J Hepatol > Volume 15(1); 2009 > Article
The Korean Journal of Hepatology 2009;15(1): 52-58.
doi: https://doi.org/10.3350/kjhep.2009.15.1.52
Virologic response to adefovir dipivoxil monotherapy is not durable in HBeAg-positive, Lamivudine-resistant chronic hepatitis B patients
Hyun Wook Jung , Moon Seok Choi , Kap Hyun Kim , Sung Hyun Park , Keum Yeon Kwak , Joon Hyoek Lee , Kwang Cheol Koh , Seung Woon Paik , Byung Chul Yoo
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
/Aims: It has been shown that adefovir dipivoxil is an effective antiviral agent in the treatment of chronic hepatitis B (CHB), not only in wild-type hepatitis B virus (HBV) infection, but also in lamivudine-resistant (LAMV-R) cases. However, little is known about the durability of the virologic response to adefovir in LAMV-R CHB patients. Methods: Fifteen HBV e-antigen (HBeAg)-positive, LAMV-R CHB patients showed a virologic response to adefovir monotherapy. These patients received additional adefovir for at least a further 12 months. The virologic relapse rate after discontinuation of adefovir was evaluated. In addition, predictive factors associated with virologic relapse were investigated. Results: The median level of serum HBV DNA before adefovir administration was 7,457,840 IU/mL (range 107,920-99,524,960 IU/mL). The median duration of adefovir treatment was 30 months (range 14-46 months). During a median follow-up period of 14 months after discontinuation of adefovir, the 1-, 2-, 3-, 6-, and 12-month cumulative relapse rates were 26.7%, 53.3%, 73.3%, 80%, and 80%, respectively. High pretreatment HBV DNA levels were found to be the only factor that was predictive of off-therapy relapse. Conclusions: Our data suggest that the adefovir-monotherapy-induced virologic response is not durable in most patients with LAMV-R HBeAg-positive CHB, especially in those with a high pretreatment HBV DNA level. (Korean J Hepatol 2008;15:52-58)
KeyWords: Adefovir dipivoxil; Lamivudine; Drug Resistance, Viral; Durability

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