title: Treatment of lamivudine-resistant chronic hepatitis B infection: a multicenter retrospective study.
abstract: OBJECTIVE
  To compare the efficacy of rescue therapies in lamivudine (LAM)-resistant chronic hepatitis B (CHB) infections including: (1) adefovir dipivoxil (ADV) monotherapy, (2) ADV plus LAM combination therapy and (3) entecavir (ETV) 1.0 mg monotherapy.
  
  
  METHODS
  The authors designed a multicenter-retrospective study. Eight institutions participated in the study from Korea.
  
  
  RESULTS
  A total of 343 LAM-resistant CHB patients were enrolled. The proportion of patients with undetectable serum hepatitis B virus (HBV) DNA levels at month 24 after the initiation of rescue therapy was higher in the ADV plus LAM combination therapy group (39/64, 60.9%) than in the ADV monotherapy (50/126, 39.7%) and ETV 1.0 mg monotherapy (19/48, 39.6%) groups (p = 0.014). Mean serum HBV DNA levels at 24 months were 2.07 ± 1.21 log(10) IU/ml in the ADV plus LAM combination therapy group, 2.74 ± 1.74 log(10) IU/ml in the ADV monotherapy group and 3.08 ± 1.97 log(10) IU/ml in the ETV 1.0 mg monotherapy group (p = 0.014). In multivariate analysis, a finding of undetectable serum HBV DNA level at 6 months and ADV plus LAM combination therapy (vs. ADV) was an independent factor for predicting undetectable serum HBV DNA at month 24 (odds ratio, 1.003; 95% confidence interval, 1.000-1.006; p = 0.026).
  
  
  CONCLUSIONS
  ADV plus LAM combination therapy is more effective in reducing viral load than switching to ADV or ETV 1.0 mg in patients with LAM-resistant CHB.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sun Jae
authors.initials: SJ
authors.lastname: Lee
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Seong Gyu
authors.initials: SG
authors.lastname: Hwang
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Eileen L
authors.initials: EL
authors.lastname: Yoon
authors.forename: Joong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Kim
authors.forename: Sang Jong
authors.initials: SJ
authors.lastname: Park
authors.forename: Young Min
authors.initials: YM
authors.lastname: Park
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Se Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Jeong Il
authors.initials: JI
authors.lastname: Lee
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: In Hee
authors.initials: IH
authors.lastname: Kim
authors.forename: Hyung Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sun Pyo
authors.initials: SP
authors.lastname: Hong
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D053208:Kaplan-Meier Estimate; D019259:Lamivudine / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D063065:Organophosphonates / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; D000225:Adenine; C106812:adefovir dipivoxil