title: Lamivudine plus adefovir combination therapy for lamivudine resistance in hepatitis-B-related hepatocellular carcinoma patients.
abstract: OBJECTIVE
  Lamivudine (LAM) plus adefovir (ADV) combination therapy has been accepted as one of the best treatments for LAM-resistant chronic hepatitis B (CHB). The aim of this study was to determine the efficacy of this combination therapy in hepatocellular carcinoma (HCC) patients.
  
  
  METHODS
  The medical records of CHB patients who developed LAM resistance and were treated with LAM plus ADV combination therapy for more than 6 months were reviewed. Their virological response (VR; undetectable HBV DNA) and biochemical response (BR; alanine aminotransferase normalization) were evaluated, and the findings of HCC and non-HCC patients were compared.
  
  
  RESULTS
  The data from 104 patients (19 with HCC and 85 without HCC) were analyzed. The VR rates did not differ significantly between the HCC and non-HCC groups: 33.3% vs. 55.6% at 12 months (P=0.119), 58.3% vs. 67.2% at 24 months (P=0.742), 50% vs. 69.8% at 36 months (P=0.280), and 66.7% vs. 71.0% at 48 months (P=1.000). The BR rates also did not differ significantly between the groups: 55.6% vs. 84.0% at 12 months (P=0.021), 58.3% vs. 83.8% at 24 months (P=0.057), 70.0% vs. 77.8% at 36 months (P=0.687), and 66.7% vs. 80.6% at 48 months (P=0.591).
  
  
  CONCLUSIONS
  The efficacy of LAM plus ADV combination therapy is comparable in HCC and non-HCC patients.
authors.affiliation: Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jeong Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Soon Young
authors.initials: SY
authors.lastname: Ko
authors.forename: Won Hyeok
authors.initials: WH
authors.lastname: Choe
authors.forename: So Young
authors.initials: SY
authors.lastname: Kwon
authors.forename: Chang Hong
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D004279:DNA, Viral / Q000032:analysis; D004334:Drug Administration Schedule; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005838:Genotype; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D015994:Incidence; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D019259:Lamivudine; C053001:adefovir; D000225:Adenine
keywords: Adefovir; Chronic hepatitis B; Hepatocellular carcinoma; Lamivudine; Resistance