Adefovir dipivoxil monotherapy and combination therapy with lamivudine for the t

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Antivir Ther. 2007;12(1):41-6.

Adefovir dipivoxil monotherapy and combination therapy with lamivudine for

the treatment of chronic hepatitis B in an Asian population.

Fung J, Lai CL, Yuen JC, Wong DK, Tanaka Y, Mizokami M, Yuen MF.

Department of Medicine, The University of Hong Kong, Queen Hospital,

Hong Kong.

AIM: To determine differences in Chinese patients treated with adefovir

(ADV) monotherapy or ADV in combination with lamivudine (3TC) after

development of resistance to 3TC, with respect to biochemical improvement,

HBV DNA suppression and development of subsequent ADV resistance. METHODS:

All hepatitis B patients with 3TC resistance treated with ADV for 3 months

or more at our centre were included, and monitored 3-6 monthly for

biochemical and virological response, and development of ADV resistance.

RESULTS: A total of 56 patients were included, 50% switched to ADV

monotherapy and 50% received combination 3TC/ADV therapy. Median follow-up

was 15.5 months. Normalization of alanine aminotransferase (ALT) occurred in

25 (89%) patients in the ADV group compared with 24 (86%) in the 3TC/ADV

group (P = 0.686). Virological response (VR) was achieved in seven (35%)

patients in the ADV group at 12 months compared with five (28%) in the

3TC/ADV group (P = 0.637). By 24 months, seven (64%) patients in the ADV

group achieved VR compared with two (40%) in the 3TC/ADV group (P = 0.377).

Cumulative probability of developing genotypic ADV resistance in the ADV

group at 24 months was 18% compared with 7% in the 3TC/ADV group (P = 0.94).

CONCLUSION: There was no obvious improvement in ALT normalization and

virological suppression or reduction in the development of ADV-resistant

mutations with 3TC/ADV therapy compared with ADV monotherapy. Further

studies with longer follow-ups are required to determine whether combination

3TC/ADV therapy will reduce the emergence of ADV resistance compared with

ADV monotherapy.

PMID: 17503746 [PubMed - in process]

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