High rate of adefovir-lamivudine combination therapy in nucleoside-naïve patients with chronic hepatitis B in France: results of a national survey in 1730 patients.
OBJECTIVE
This study describes the types of therapy used in chronic hepatitis B (CHB) in France and patient characteristics according to therapy.


METHODS
This was a descriptive, multicenter, retrospective study in 1730 patients (54 centers). We collected information about demographics, epidemiology, severity of hepatitis B virus-related liver disease, antiviral therapy, response (hepatitis B viral DNA and alanine aminotransferase normalization changes), dose modification, or treatment interruption.


RESULTS
Approximately, 60% of patients enrolled had never been treated for CHB and 33.1% were currently receiving treatment (47% first line). Of those receiving treatment, 30% were receiving adefovir-lamivudine combination. Of those receiving first-line therapy, 40, 30, and 15% were receiving lamivudine, adefovir, or adefovir-lamivudine combination, respectively. Complete and partial virological responses were seen in 59 and 13% of patients, respectively. In patients having been treated at least once, biochemical response was seen in 45%. Lamivudine or adefovir-resistant mutants were detected in 32.6 and 22.1% of patients treated by these antiviral agents, respectively.


CONCLUSIONS
In France, among patients with CHB, we observed that one-third were receiving therapy, and, of these, 30% were receiving first-line (15%) or second-line (15%) adefovir-lamivudine combination therapy. This observation highlights that clinical practice is influenced by available scientific data on resistance induced by monotherapy.
Marcellin
Patrick
P
Hôpital Beaujon, Service d'Hépatologie, Clichy, France. patrick.marcellin@bjn.ap-hop-paris.fr
Cadranel
Jean-François
JF
Fontanges
Thierry
T
Poynard
Thierry
T
Pol
Stanislas
S
Trepo
Christian
C
Blin
Patrick
P
Bregman
Bruno
B
Schmidely
Nathalie
N
Roudot-Thoraval
Françoise
F
Zarski
Jean-Pierre
JP
D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D024921:Drug Resistance, Multiple, Viral; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D005602:France / Q000453:epidemiology; D019538:Health Care Surveys; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D063065:Organophosphonates; D019259:Lamivudine; C053001:adefovir; D000410:Alanine Transaminase; D000225:Adenine