Authors: Gallego, A.¹; Sheldon, J.²; García-Samaniego, J.³; Margall, N.⁴; Romero, M.³; Hornillos, P.⁴; Soriano, V.²; Enríquez, J.¹

Source: Journal of Viral Hepatitis, Volume 15, Number 5, May 2008 , pp. 392-398(7)

Publisher: Wiley-Blackwell

Abstract:

Summary. 

The aims of the present study were to assess initial virological response (IVR) to adefovir (ADV) treatment for chronic hepatitis B, to identify patients with suboptimal response and to determine the incidence of ADV-resistant mutants. All patients treated with ADV for at least 12 months were evaluated for virological response and ADV resistance. IVR was defined as a reduction ≥4 log₁₀ IU/mL in hepatitis B virus (HBV)-DNA at month 6. Forty-two patients were analysed. Mean treatment duration was 23 ± 7 months; 50% had prior lamivudine (LAM) therapy (LAM resistance 62%); 88% were hepatitis B e antigen (HBeAg)-negative; and 76% carried genotype D. IVR was seen in 40.5% of patients. Higher baseline ALT level was the only factor associated with IVR (P = 0.043). Patients with IVR achieved undetectable HBV-DNA at month 12 in 77% of cases compared with only 5% of those without IVR (P < 0.001). Five (12%) patients developed ADV-resistant mutations: rtN236T in four cases and one case with an rtV207L change, which has not been previously reported. This mutation was accompanied by viral rebound and alanine aminotransferase (ALT) flare. The cumulative probability of ADV-resistant mutations at 12 and 24 months was 5% and 17% respectively. IVR defined as a reduction ≥4 log₁₀IU/mL in HBV-DNA at month 6 is a useful tool to predict virological response at month 12 and to identify patients with suboptimal response to ADV. Cumulative probability of ADV resistance is higher than previously reported for nucleos(t)ide-naïve patients.

Keywords: adefovir; initial virological response; mutations; resistance; suboptimal response

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2893.2008.00966.x

Affiliations: 1: Gastroenterology Department, Hospital Sta. Creu i St. Pau, Barcelona 2: Department of Infectious Diseases, Hospital Carlos III, Madrid 3: Hepatology Unit, CIBEREHD, Hospital Carlos III, Madrid 4: Microbiology Department, Hospital Sta. Creu i St. Pau, Barcelona, Spain

Publication date: 2008-05-01

Related content

• In this: publication
• By this: publisher
• In this Subject: Gastroenterology
• By this author: Gallego, A. ;  Sheldon, J. ;  García-Samaniego, J. ;  Margall, N. ;  Romero, M. ;  Hornillos, P. ;  Soriano, V. ;  Enríquez, J.

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers