Antiviral efficacy of combination therapy with entecavir and adefovir for entecavir/lamivudine-resistant hepatitis B virus with or without adefovir resistance

✍ Scribed by Hyo-Joon Yang; Jeong-Hoon Lee; Yoon Jun Kim; Jung-Hwan Yoon; Hyo-Suk Lee

• Publisher: John Wiley and Sons
• Year: 2012
• Tongue: English
• Weight: 172 KB
• Volume: 84
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/jmv.23229

✦ Synopsis

Abstract

There is little clinical information on the management of hepatitis B virus (HBV) that is resistant to multiple drugs including entecavir (ETV). The present retrospective cohort study assessed the antiviral efficacy of ETV/adefovir dipivoxil (ADV) combination therapy for ETV‐resistant HBV with prior lamivudine (LAM) resistance, and either with or without previous ADV resistance. The cumulative probability of achieving a virological response (undetectable serum HBV DNA) was compared by Kaplan–Meier analysis and the Breslow method. Seventeen patients with ETV‐resistant HBV who were treated with ETV/ADV combination therapy for at least 6 months at a tertiary care center, were included; seven had dual resistance to ETV and LAM [ADV‐r(−) group] and 10 had triple resistance to ETV, LAM, and ADV [ADV‐r(+) group]. The median follow‐up period was 9 months (range, 6–23). A virological response was noted in seven patients after a median of 3 months (range, 3–12) of treatment; five in the ADV‐r(−) group and two in the ADV‐r(+) group. The cumulative probability of a virological response was significantly higher in the ADV‐r(−) group than in the ADV‐r(+) group (6 months cumulative probability, 57.1% vs. 11.1%). In conclusion, ETV/ADV combination therapy led to virological responses in five of seven patients with resistance to ETV and LAM, but a significantly poorer response in patients with prior ADV resistance than in those without prior ADV resistance. Therefore, ETV/ADV combination therapy could be a useful therapeutic option for ETV‐ and LAM‐resistant HBV without prior ADV resistance. J. Med. Virol. 84:424–430, 2012. © 2011 Wiley Periodicals, Inc.