Adefovir rapidly suppresses hepatitis B in HBeAg-negative patients developing genotypic resistance to lamivudine

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Abstract

Progression of hepatitis B in patients with lamivudine-resistant strains is slowed down by adefovir dipivoxil (ADV). Whether the time point of ADV administration (genotypic vs. phenotypic resistance) influences the outcome of therapy is unknown. We compared the outcome of ADV therapy in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B patients with genotypic and phenotypic resistance to lamivudine. Ten milligrams of ADV was administered daily for 2 years to 46 HBeAg-negative patients at the time of phenotypic resistance (group A, >6 log 10 copies/mL of hepatitis B virus [HBV] DNA and high alanine aminotransferase [ALT] levels) and 28 patients at the time of genotypic resistance (group B, 3-6 log 10 copies/mL of HBV-DNA and normal ALT). HBV DNA was assessed every 2 months using Versant 3.0 assay, and lamivudine resistance was confirmed via INNO-LiPA assay in all patients. By month 3, HBV DNA tested negative in all patients from group B compared with only 20 (46%) in group A (P <.0001). The 2-year rates of virological response were 100% in the former patients and 78% in the latter ones (P <.0001). ALT levels remained persistently normal in all group B patients, whereas in group A patients they normalized at rates of 50% at month 6 (P <.0001), 72% at month 12 (P <.01), and 93% at month 24. None of the patients developed ADV resistance or ADV-related side effects. In conclusion, to optimize antiviral treatment in HBeAg-negative patients selecting resistant strains to lamivudine, ADV should be added to lamivudine as soon as genotypic resistance is detected.

Original languageEnglish
Pages (from-to)1414-1419
Number of pages6
JournalHepatology
Volume42
Issue number6
DOIs
Publication statusPublished - Dec 2005

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Lamivudine
Hepatitis B e Antigens
Hepatitis B
Hepatitis B virus
Alanine Transaminase
DNA
adefovir
Chronic Hepatitis B
adefovir dipivoxil
Antiviral Agents
Therapeutics

ASJC Scopus subject areas

  • Hepatology

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Adefovir rapidly suppresses hepatitis B in HBeAg-negative patients developing genotypic resistance to lamivudine. / Lampertico, Pietro; Viganò, Mauro; Manenti, Elena; Iavarone, Massimo; Lunghi, Giovanna; Colombo, Massimo.

In: Hepatology, Vol. 42, No. 6, 12.2005, p. 1414-1419.

Research output: Contribution to journalArticle

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