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.

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Eur J Gastroenterol Hepatol. 2010 Nov;22(11):1290-6.

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.

Marcellin P, Cadranel JF, Fontanges T, Poynard T, Pol S, Trepo C, Blin P,

Bregman B, Schmidely N, Roudot-Thoraval F, Zarski JP.

Hôpital Beaujon, Service d'Hépatologie, Clichy, France.

patrick.marcellin@...

Abstract

BACKGROUND/AIMS: 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.

CONCLUSION: 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.

PMID: 20964259 [PubMed - in process]