Short-term overlap lamivudine treatment with adefovir dipivoxil in patients with lamivudine-resistant chronic hepatitis B

World J Gastroenterol. 2008 Mar 21;14(11):1781-4. doi: 10.3748/wjg.14.1781.

Abstract

Aim: To evaluate the efficacy of short-term overlap lamivudine therapy with adefovir in patients with lamivudine-resistant and naive chronic hepatitis B, we compared patients receiving overlap therapy with those receiving adefovir alone.

Methods: Eighty patients who had received lamivudine treatment for various periods and had a lamivudine-resistant liver function abnormality were enrolled. Forty of these patients received adefovir treatment combined with lamivudine treatment for > or = 2 mo, while the other 40 received adefovir alone. We assessed the levels of hepatitis B virus (HBV) DNA at 0, 12 and 48 wk and serum alanine aminotransferase (ALT) levels after 0, 12, 24 and 48 wk of adefovir treatment in each group.

Results: We found serum ALT became normalized in 72 (87.5%) of the 80 patients, and HBV DNA decreased by > or = 2 log10 copies/mL in 60 (75%) of the 80 patients at the end of a 48-wk treatment. HBV DNA levels were not significantly different between the groups. The improvements in serum ALT were also not significantly different between the two groups.

Conclusion: These findings suggest short-term overlap lamivudine treatment results in no better virological and biological outcomes than non-overlap adefovir monotherapy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenine / administration & dosage
  • Adenine / analogs & derivatives*
  • Adult
  • Alanine Transaminase / blood
  • Antiviral Agents / administration & dosage*
  • DNA, Viral / blood
  • Drug Administration Schedule
  • Drug Resistance, Viral*
  • Drug Therapy, Combination
  • Female
  • Hepatitis B virus / drug effects
  • Hepatitis B virus / genetics
  • Hepatitis B, Chronic / diagnosis
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / enzymology
  • Humans
  • Lamivudine / administration & dosage*
  • Male
  • Middle Aged
  • Organophosphonates / administration & dosage*
  • Time Factors
  • Treatment Outcome
  • Viral Load

Substances

  • Antiviral Agents
  • DNA, Viral
  • Organophosphonates
  • Lamivudine
  • Alanine Transaminase
  • Adenine
  • adefovir dipivoxil