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Clinical and virological effects during two years of ongoing adefovir dipivoxil in the treatment of lamivudine-resistant chronic hepatitis B infection.
- Source :
-
Transplantation proceedings [Transplant Proc] 2005 Nov; Vol. 37 (9), pp. 3957-9. - Publication Year :
- 2005
-
Abstract
- Objective: Our aim was to evaluate the efficacy and safety of adding adefovir to lamivudine therapy for hepatitis B virus (HBV)-infected patients resistant to Ramivudine.<br />Patients and Methods: Among 17 studied patients, 7 had chronic active HBV infection and 10 were posttransplant with HBV infection (9 with de novo HBV). They received lamivudine plus adefovir therapy for 2 years. We assessed reductions in serum HBV-DNA and alanine aminotransferase (ALT) levels, loss of HBeAg (in HBeAg+ cases), and HBsAg clearance.<br />Results: A virological response, as defined by HBV-DNA below the cut off by hybridization, was observed in 12 (70.6%) patients and loss of HBeAg in 4 (44.4%) of the 9 initially HBeAg-positive cases. A biochemical response, defined as a decreased serum ALT to the normal range, occurred in 4 (26.7%) patients. Median serum creatinine increased in 3 of 15 (20%) patients, excluding those on hemodialysis. There were two noteworthy cases of sustained HBsAg seroconversion with adefovir (11.8%): one patient with de novo HBV infection posttransplantation and positive hepatitis C virus-RNA serology, and one patient with decompensated HBV cirrhosis in whom viral replication ceased, making him eligible for transplantation.<br />Conclusions: Currently, adefovir is an effective rescue therapy that broadens the existing range of options for patients with lamivudine-resistant chronic hepatitis B infection, particularly those with decompensated cirrhosis awaiting a liver graft, and those with recurrent posttransplantation HBV. The relatively small biochemical response seen in these patients may be attributable to the high prevalence of concomitant hepatitis C virus infection (41%).
- Subjects :
- Adenine therapeutic use
Aged
DNA, Viral blood
Drug Resistance, Viral
Female
Hepatitis B e Antigens analysis
Hepatitis B virus genetics
Hepatitis B virus isolation & purification
Humans
Lamivudine therapeutic use
Male
Middle Aged
Renal Dialysis
Treatment Failure
Virus Replication
Adenine analogs & derivatives
Antiviral Agents therapeutic use
Hepatitis B, Chronic drug therapy
Liver Transplantation
Organophosphonates therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0041-1345
- Volume :
- 37
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 16386595
- Full Text :
- https://doi.org/10.1016/j.transproceed.2005.09.123