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Combination of Lamivudine and adefovir therapy in HBeAg‐positive chronic hepatitis B patients with poor response to adefovir monotherapy
Author(s) -
Wang L.C.,
Chen E.Q.,
Cao J.,
Liu L.,
Wang J.R.,
Lei B.J.,
Tang H.
Publication year - 2010
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2009.01164.x
Subject(s) - adefovir , lamivudine , medicine , gastroenterology , hbeag , combination therapy , chronic hepatitis , seroconversion , hepatitis b , complete response , hepatitis b virus , virology , hbsag , virus , chemotherapy
Summary. At present, there is no consensus treatment for patients who have poor response to Adevofir dipivoxil (ADV) monotherapy and no ADV‐associated mutation. The purpose of this study was to evaluate the effect of a new therapeutic strategy combining Lamivudine (LAM) and ADV in patients with HBeAg‐positive chronic hepatitis B (CHB) and poor response to ADV monotherapy. Thirty‐one patients with chronic hepatitis B with HBV DNA ≥10 4 copies/mL after 48 weeks of ADV monotherapy were included and received ADV plus LAM for 24 weeks. Compared with ADV monotherapy, ADV + LAM had an improved response rate at weeks 12 and 24 – compared with baseline, the median decrease in HBV‐DNA level at week 12 and 24 were 1.27 and 2.03 log respectively. The virological response (VR) rate (HBV‐DNA level <10 3 copies/mL) was 6.5% and 35.5% at weeks 12 and 24, respectively; the biochemical response (BR) rate (normalization of alanine aminotransferase levels) was 67.8% and 100%, respectively; the HBeAg loss rate was 6.9% and 34.5%, respectively; and the seroconversion rate (from HBeAg to HBeAb) was 3.5% and 6.9% respectively. No ADV‐associated mutation was detected at baseline. After combination therapy for 24 weeks, no LAM‐resistant or ADV‐resistant mutations were detected. Only one patient had a mild adverse reaction. In conclusion, optimization of therapy combining LAM and ADV may be a good choice for patients with hepatitis B who have a poor response to ADV monotherapy.