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Entecavir+tenofovir vs. lamivudine/telbivudine+adefovir in chronic hepatitis B patients with prior suboptimal response
- Source :
- Clinical and Molecular Hepatology, Vol 26, Iss 3, Pp 352-363 (2020), Clinical and Molecular Hepatology
- Publication Year :
- 2020
- Publisher :
- Korean Association for the Study of the Liver, 2020.
-
Abstract
- Background/Aims: Suboptimal responses to lamivudine or telbivudine plus adefovir (LAM/LdT+ADV) rescue therapy are common in patients with LAM-resistant hepatitis B virus (HBV) infections. We compared patients switched to entecavir plus tenofovir (ETV+TDF) to those maintained on LAM/LdT+ADV.Methods: This prospective randomized controlled trial examined 91 patients whose serum HBV DNA levels were greater than 60 IU/mL after at least 24 weeks of treatment with LAM/LdT+ADV for LAM-resistant HBV. Patients were randomized to receive a new treatment (ETV+TDF, n=45) or maintained on the same treatment (LAM/LdT+ADV, n=46) for 48 weeks. Patients with baseline ADV resistance were excluded.Results: Compared to LAM/LdT+ADV group, ETV+TDF group had more patients with a virologic response (42/45 [93.33%] vs. 3/46 [6.52%], PPP=0.005) and LAM/LdT+ADV maintenance therapy (P=0.001) were negatively associated with virologic response. At week 48, additional ADV- or ETV-associated mutations were cleared in ETV+TDF group, but such mutations were present in 4.3% of patients in LAM/LdT+ADV group (P=0.106). The two groups had similar rates of adverse events.Conclusions: ETV+TDF combination treatment led to a significantly higher rate of virologic response compared to LAM/LdT+ADV combination treatment in patients with LAM-resistant HBV who had suboptimal responses to LAM/LdT+ADV regardless of HBV genotypic resistance profile (NCT01597934).
- Subjects :
- 0301 basic medicine
adefovir
medicine.medical_specialty
Guanine
viruses
Organophosphonates
medicine.disease_cause
Gastroenterology
law.invention
03 medical and health sciences
0302 clinical medicine
Hepatitis B, Chronic
Maintenance therapy
Randomized controlled trial
law
immune system diseases
Internal medicine
Telbivudine
hemic and lymphatic diseases
Adefovir
medicine
Humans
lcsh:RC799-869
Adverse effect
Molecular Biology
Hepatitis B virus
Hepatology
business.industry
Adenine
antiviral drug resistance
Lamivudine
virus diseases
Entecavir
030112 virology
tenofovir
030211 gastroenterology & hepatology
Original Article
lipids (amino acids, peptides, and proteins)
lcsh:Diseases of the digestive system. Gastroenterology
lamivudine
business
medicine.drug
entecavir
Subjects
Details
- Language :
- English
- ISSN :
- 22872728
- Volume :
- 26
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Clinical and Molecular Hepatology
- Accession number :
- edsair.doi.dedup.....f7dc0335b7504b412207d90c4ce2f571