title: [Adefovir dipivoxil compassionate use program in Spain: efficacy and resistance analysis].
abstract: OBJECTIVE
  The extended treatment with lamivudine in patients with chronic hepatitis B is associated with the emergence of resistances. Patients with resistance to lamivudine show a loss of biochemical and virological responses and a higher progression of their liver disease. Adefovir dipivoxil, an analogue of the nucleotides, is effective for the treatment of patients with resistance to lamivudine. The aim of this study was to evaluate the efficacy, safety and resistance of adefovir dipivoxil in patients with chronic hepatitis B refractory to treatment with lamivudine.
  
  
  METHODS
  One hundred and twenty hepatits B virus patients refractory to lamivudine were treated with adefovir dipivoxil. Seventy-four patients were followed up during two years. In all cases, the hepatitis B virus-DNA was determined by polymerase chain reaction, and in those cases without response to treatment, the presence of resistances to adefovir and lavimudine were studied.
  
  
  RESULTS
  At the second year of treatment, we observed a biological response of 54.1%, a biochemical response of 62.2%, while an elimination of hepatitis B e antigen was seen in 21% cases. 20% patients developed resistance to adefovir dipivoxil, and the most frequent detected mutations were: A181V, A181T and N236T. Drug safety was excellent; in fact, only one adverse effect related to the drug was detected.
  
  
  CONCLUSIONS
  Treatment with adefovir dipivoxil for 2 years in mono-therapy in patient who are previously non-responders to lavimudine is associated with a high biochemical and virologycal response with an excellent safety. At the second year of treatment, the adefovir dipivoxil resistance rate is 20%.
authors.affiliation: Servicio de Hepatología, Hospital Universitari Vall d'Hebron, Barcelona, España. mbuti@hg.vhbron.es
authors.forename: María
authors.initials: M
authors.lastname: Buti
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodríguez Frías
authors.forename: José Luis
authors.initials: JL
authors.lastname: Calleja
authors.forename: Rosendo
authors.initials: R
authors.lastname: Jardí
authors.forename: Fernando
authors.initials: F
authors.lastname: Pons
authors.forename: Javier
authors.initials: J
authors.lastname: Crespo
authors.forename: Teresa
authors.initials: T
authors.lastname: Casanovas
authors.forename: Jaime
authors.initials: J
authors.lastname: Enríquez
authors.forename: Fernando
authors.initials: F
authors.lastname: Carnicer
authors.forename: Manuel
authors.initials: M
authors.lastname: Romero
authors.forename: Manuel
authors.initials: M
authors.lastname: García Bengoechea
authors.forename: Martín
authors.initials: M
authors.lastname: Prieto
authors.forename: Javier
authors.initials: J
authors.lastname: García Samaniego
authors.forename: Manuel
authors.initials: M
authors.lastname: Miras
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez Roldán
authors.forename: Magdalena
authors.initials: M
authors.lastname: Rueda
authors.forename: Rafael
authors.initials: R
authors.lastname: Esteban
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D005260:Female; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D013030:Spain
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D019259:Lamivudine; D000225:Adenine; C106812:adefovir dipivoxil