title: [Antiviral therapy for patients with chronic hepatitis B with multi-drug resistance to nucleoside analogues].
abstract: In 18 of 547 patients who had received nucleoside analogue preparations for 1 year or more, multi-drug resistance was detected, after a median follow-up of 53 months. No patient showed liver failure related to multi-drug resistance acquisition. Multi-drug resistance was associated with entecavir (ETV) therapy in 7 lamivudine (LAM) -resistant patients, combination therapy with adefovir dipivoxil (ADV) in 8 LAM-resistant patients, LAM switching to ETV in 2 patients, and initial ETV administration in 1. For treatment, combination therapy with LAM and ADV was performed. In non-responders, combination therapy with ADV and ETV was employed. In all LAM- and ADV-resistant patients, and the HBV DNA level decreased to 3.0LC/ml or less. However, a similar decrease was noted in 7 (58.3%) of 12 LAM- and ETV-resistant patients. Of the 18 patients, 1 did not respond to combination therapy with ADV and ETV. Therapy with tenofovir disoproxil fumarate (TDF) was required.
authors.affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital. i.ozeki@ja-hokkaidoukouseiren.or.jp
authors.forename: Itaru
authors.initials: I
authors.lastname: Ozeki
authors.forename: Shuhei
authors.initials: S
authors.lastname: Hige
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Karino
authors.forename: Mutsuumi
authors.initials: M
authors.lastname: Kimura
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Arakawa
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nakajima
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Kuwata
authors.forename: Takumi
authors.initials: T
authors.lastname: Ohmura
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sato
authors.forename: Joji
authors.initials: J
authors.lastname: Toyota
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage; D024921:Drug Resistance, Multiple, Viral; D005260:Female; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009705:Nucleosides / Q000494:pharmacology*; D063065:Organophosphonates / Q000008:administration & dosage
chemical_list: D000998:Antiviral Agents; D009705:Nucleosides; D063065:Organophosphonates; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000225:Adenine