Virologic response at 12 months of treatment predicts sustained antiviral efficacy in patients with adefovir-treated Lamivudine-resistant chronic hepatitis B.
OBJECTIVE
The aim of our study was to define the potential role of virologic response at 12 months of treatment (VR12) in predicting subsequent virologic and clinical outcomes in adefovir (ADV)-treated lamivudine-resistant chronic hepatitis B.


METHODS
Two hundred and four patients with lamivudine-resistant chronic hepatitis B virus (HBV) treated with ADV monotherapy were included. Serum HBV DNA was quantified by real-time polymerase chain reactions. VR12 was defined as a HBV DNA level of less than 4 log(10) copies/mL after 12 months of ADV treatment.


RESULTS
VR12 was observed in 110 of the 204 patients (54%). The mean HBV DNA reductions from baseline after 12 months of ADV treatment were 3.8 and 1.9 log(10) copies/mL in patients with and without VR12, respectively (p<0.001). The hepatitis B "e" antigen (HBeAg) seroconversion rates in patients with and without VR12 were 32% and 14% at 12 months treatment, respectively (p=0.018), and 40% and 27% at 24 months of treatment (p=0.032). The genotypic mutation rates to ADV in patients with and without VR12 were 0% and 6% at 12 months of treatment, respectively (p=0.033), and 21% and 42% at 24 months (p=0.012). The rates of viral breakthrough in patients with and without VR12 were 0% and 7% at 12 months of treatment, respectively (p=0.072), and 9% and 25% at 24 months (p=0.006).


CONCLUSIONS
Patients without VR12 may need to switch to or add on other potent antiviral drugs in their medical regimens.
Jung
Young Kul
YK
Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Yeon
Jong Eun
JE
Han
Woo Sik
WS
Kim
Ji Hoon
JH
Kim
Jeong Han
JH
Park
Jong-Jae
JJ
Kim
Jae Seon
JS
Bak
Young-Tae
YT
Yoo
Wangdon
W
Hong
Sun Pyo
SP
Kim
Soo-Ok
SO
Kwon
So Young
SY
Byun
Kwan Soo
KS
Lee
Chang Hong
CH