𝔖 Bobbio Scriptorium
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Resistance of HBV to adefovir dipivoxil: A case for combination antiviral therapy?

✍ Scribed by Costica Aloman; Jack R. Wands

Book ID
102243224
Publisher
John Wiley and Sons
Year
2003
Tongue
English
Weight
64 KB
Volume
38
Category
Article
ISSN
0270-9139

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✦ Synopsis

Background & Aims: Adefovir dipivoxil effectively inhibits both hepatitis B virus (HBV) replication and disease activity in patients with chronic hepatitis B. Resistance to treatment was not observed in 2 recent large placebo-controlled 48-week studies with this drug. The aim of this study was to characterize adefovir resistance in a patient who developed clinical and virologic evidence of breakthrough during a 96-week course of treatment. Methods: HBV DNA was PCR amplified and sequenced. Phenotypic studies used patient-derived HBV as well as specific mutations created by site-directed mutagenesis of a HBV/baculovirus recombinant. Results: Following the commencement of treatment with adefovir dipivoxil, the patient initially responded with a 2.4 log10 decrease in serum HBV DNA and normalization of alanine aminotransaminase levels by week 16. During the second year of treatment, however, serum HBV DNA rose progressively, eventually returning to near-pretreatment levels. This increase in viral replication was as-

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