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Adefovir dipivoxil is effective for the treatment of cirrhotic patients with lamivudine failure.
- Source :
-
Liver International . Mar2009, Vol. 29 Issue 3, p420-426. 7p. 3 Charts, 2 Graphs. - Publication Year :
- 2009
-
Abstract
- Background/Aims: Data on the efficacy of adefovir dipivoxil (ADV) in elderly and cirrhotic patients with lamivudine-resistant (LAM-R) chronic hepatitis B are scarce. This retrospective cohort study evaluated the safety and efficacy of ADV in this specific patient population. Methods: Sixty-eight cirrhotic LAM-R patients, of whom 19 (27.9%) were elderly (≥65 years of age) and nine had severe disease (two post-orthotopic liver transplantation, four pre-orthotopic liver transplantation and three decompensated), with hepatitis B virus (HBV) infection received ADV. Virological and biochemical responses to the addition of ADV were analysed. Results: At inclusion, all patients were receiving LAM; ADV was added. 75.4% of patients received a combination of LAM and ADV throughout this study for a median treatment duration of 12.6 months; the remainder received ADV with an overlap with LAM treatment for a median duration of 7.9 months. At the end of follow-up, 41.2% of patients had undetectable HBV DNA (≤2000 copies/ml) with a median reduction of 3.4 log10 copies/ml. Time to reach undetectable HBV DNA was dependent on baseline alanine aminotransferase (ALT) levels and HBeAg status. Normalization of serum ALT levels was observed in 55.2% (32/58) of patients. In patients who were HBeAg positive at baseline, HBeAg loss and seroconversion occurred in 23% (9/39) and 10% (4/39) respectively. No resistance mutations and no significant side effects were observed during the study period. Conclusion: Adefovir dipivoxil provides effective and safe treatment in cirrhotic and elderly patients who failed LAM therapy. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14783223
- Volume :
- 29
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Liver International
- Publication Type :
- Academic Journal
- Accession number :
- 36366778
- Full Text :
- https://doi.org/10.1111/j.1478-3231.2008.01867.x