Rescue therapy with adefovir in decompensated liver cirrhosis patients with lamivudine-resistant hepatitis B virus
Korean Journal of Hepatology 2014³â 20±Ç 2È£ p.168 ~ p.176
¿ìÇö¿µ(Woo Hyun-Young) - Pusan National University College of Medicine Department of Internal Medicine
ÃÖÁ¾¿µ(Choi Jong-Young) - Catholic University School of Medicine Department of Internal Medicine
À±½Â±Ô(Yoon Seung-Kew) - Catholic University College of Medicine Department of Internal Medicine
¼µ¿Áø(Suh Dong-Jin) - University of Ulsan College of Medicine Department of Internal Medicine
¹é½Â¿î(Paik Seung-Woon) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
Çѱ¤Çù(Han Kwang-Hyub) - Yonsei University College of Medicine Department of Internal Medicine
¾ö¼øÈ£(Um Soon-Ho) - Korea University College of Medicine Department of Internal Medicine
±èº´ÀÍ(Kim Byung-Ik) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
ÀÌÇåÁÖ(Lee Heon-Ju) - Yeungnam University College of Medicine Department of Internal Medicine
Á¶¸ù(Cho Mong) - Pusan National University College of Medicine Department of Internal Medicine
ÀÌõ±Õ(Lee Chun-Kyon) - National Health Insurance Corporation Ilsan Hospital Department of Internal Medicine
±èµ¿ÁØ(Kim Dong-Joon) - Inje University College of Medicine Department of Internal Medicine
ȲÀç¼®(Hwang Jae-Seok) - Keimyung University College of Medicine Department of Internal Medicine
Abstract
Background/Aims: Adefovir dipivoxil (ADV) is a nucleotide analogue that is effective against lamivudine-resistant hepatitis B virus (HBV). The aim of this study was to determine the long-term clinical outcomes after ADV rescue therapy in decompensated patients infected with lamivudine-resistant HBV.
Methods: In total, 128 patients with a decompensated state and lamivudine-resistant HBV were treated with ADV at a dosage of 10 mg/day for a median of 33 months in this multicenter cohort study.
Results: Following ADV treatment, 86 (72.3%) of 119 patients experienced a decrease in Child-Pugh score of at least 2 points, and the overall end-stage liver disease score decreased from 16¡¾5 to 14¡¾10 (mean ¡¾ SD, P<0.001) during the follow-up period. With ADV treatment, 67 patients (56.3%) had undetectable serum HBV DNA (detection limit, 0.5 pg/mL). Virologic breakthrough occurred in 38 patients (36.1%) and 9 patients had a suboptimal ADV response. The overall survival rate was 89.9%(107/119), and a suboptimal response to ADV treatment was associated with both no improvement in Child-Pugh score (¡Ã2 points; P=0.001) and high mortality following ADV rescue therapy (P=0.012).
Conclusions: Three years of ADV treatment was effective and safe in decompensated patients with lamivudineresistant HBV.
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Adefovir dipivoxil, Lamivudine-resistant, Decompensation, Hepatitis B virus
KMID :
1103920140200020168
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