Virologic response and resistance to adefovir in patients with chronic hepatitis B

Scott K. Fung, Hee Bok Chae, Robert J. Fontana, Hari Conjeevaram, Jorge Marrero, Kelly Oberhelman, Munira Hussain, Anna S F Lok

Research output: Contribution to journalArticle

289 Citations (Scopus)

Abstract

Background: The incidence and risk factors for adefovir-resistant HBV have not been clearly defined. Aims: To characterize the virologic response to adefovir, to determine the rate of adefovir resistance and to explore factors associated with initial virologic response (IVR) and adefovir resistance. Methods: All hepatitis B patients who received adefovir for ≥6 months at our center were prospectively monitored for virologic response and adefovir resistance. Results: Forty three patients were included; mean treatment duration was 18 months (range 6-45). Thirty four (79%) patients had prior lamivudine. IVR was observed in 44% patients and associated with higher pretreatment ALT (P=0.05) and the absence of HBeAg (P=0.02). Six (14%) patients were found to have adefovir-resistant mutations. The cumulative probability of genotypic resistance to adefovir at month 24 was 22%. Patients with adefovir resistance were more likely to have been switched from lamivudine to adefovir monotherapy (P=0.01), to be older (P=0.04), and to be infected with HBV genotype D (P=0.02). Conclusions: Roughly 50% of patients failed to achieve IVR on adefovir. The cumulative probability of adefovir resistance at 2 years was 22%. Our data suggest that combination of lamivudine and adefovir may prevent emergence of adefovir resistance in patients with lamivudine-resistant HBV.

Original languageEnglish (US)
Pages (from-to)283-290
Number of pages8
JournalJournal of Hepatology
Volume44
Issue number2
DOIs
StatePublished - Feb 2006

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Chronic Hepatitis B
Lamivudine
adefovir
Hepatitis B e Antigens
Hepatitis B
Genotype

Keywords

  • Adefovir
  • Antiviral resistance
  • Hepatitis B
  • Lamivudine

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Fung, S. K., Chae, H. B., Fontana, R. J., Conjeevaram, H., Marrero, J., Oberhelman, K., ... Lok, A. S. F. (2006). Virologic response and resistance to adefovir in patients with chronic hepatitis B. Journal of Hepatology, 44(2), 283-290. https://doi.org/10.1016/j.jhep.2005.10.018

Virologic response and resistance to adefovir in patients with chronic hepatitis B. / Fung, Scott K.; Chae, Hee Bok; Fontana, Robert J.; Conjeevaram, Hari; Marrero, Jorge; Oberhelman, Kelly; Hussain, Munira; Lok, Anna S F.

In: Journal of Hepatology, Vol. 44, No. 2, 02.2006, p. 283-290.

Research output: Contribution to journalArticle

Fung, SK, Chae, HB, Fontana, RJ, Conjeevaram, H, Marrero, J, Oberhelman, K, Hussain, M & Lok, ASF 2006, 'Virologic response and resistance to adefovir in patients with chronic hepatitis B', Journal of Hepatology, vol. 44, no. 2, pp. 283-290. https://doi.org/10.1016/j.jhep.2005.10.018
Fung, Scott K. ; Chae, Hee Bok ; Fontana, Robert J. ; Conjeevaram, Hari ; Marrero, Jorge ; Oberhelman, Kelly ; Hussain, Munira ; Lok, Anna S F. / Virologic response and resistance to adefovir in patients with chronic hepatitis B. In: Journal of Hepatology. 2006 ; Vol. 44, No. 2. pp. 283-290.
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abstract = "Background: The incidence and risk factors for adefovir-resistant HBV have not been clearly defined. Aims: To characterize the virologic response to adefovir, to determine the rate of adefovir resistance and to explore factors associated with initial virologic response (IVR) and adefovir resistance. Methods: All hepatitis B patients who received adefovir for ≥6 months at our center were prospectively monitored for virologic response and adefovir resistance. Results: Forty three patients were included; mean treatment duration was 18 months (range 6-45). Thirty four (79{\%}) patients had prior lamivudine. IVR was observed in 44{\%} patients and associated with higher pretreatment ALT (P=0.05) and the absence of HBeAg (P=0.02). Six (14{\%}) patients were found to have adefovir-resistant mutations. The cumulative probability of genotypic resistance to adefovir at month 24 was 22{\%}. Patients with adefovir resistance were more likely to have been switched from lamivudine to adefovir monotherapy (P=0.01), to be older (P=0.04), and to be infected with HBV genotype D (P=0.02). Conclusions: Roughly 50{\%} of patients failed to achieve IVR on adefovir. The cumulative probability of adefovir resistance at 2 years was 22{\%}. Our data suggest that combination of lamivudine and adefovir may prevent emergence of adefovir resistance in patients with lamivudine-resistant HBV.",
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AB - Background: The incidence and risk factors for adefovir-resistant HBV have not been clearly defined. Aims: To characterize the virologic response to adefovir, to determine the rate of adefovir resistance and to explore factors associated with initial virologic response (IVR) and adefovir resistance. Methods: All hepatitis B patients who received adefovir for ≥6 months at our center were prospectively monitored for virologic response and adefovir resistance. Results: Forty three patients were included; mean treatment duration was 18 months (range 6-45). Thirty four (79%) patients had prior lamivudine. IVR was observed in 44% patients and associated with higher pretreatment ALT (P=0.05) and the absence of HBeAg (P=0.02). Six (14%) patients were found to have adefovir-resistant mutations. The cumulative probability of genotypic resistance to adefovir at month 24 was 22%. Patients with adefovir resistance were more likely to have been switched from lamivudine to adefovir monotherapy (P=0.01), to be older (P=0.04), and to be infected with HBV genotype D (P=0.02). Conclusions: Roughly 50% of patients failed to achieve IVR on adefovir. The cumulative probability of adefovir resistance at 2 years was 22%. Our data suggest that combination of lamivudine and adefovir may prevent emergence of adefovir resistance in patients with lamivudine-resistant HBV.

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