Preemptive adefovir versus lamivudine for prevention of hepatitis B reactivation in chronic hepatitis B patients undergoing chemotherapy

Hepatology International
Edith Y HoGeorge K K Lau

Abstract

This proof-of-concept study compared lamivudine (LAM) with a newer antiviral agent, adefovir dipivoxil (ADF), in preventing hepatitis B virus (HBV) reactivation in chronic HBV patients undergoing chemotherapy. Hepatitis B surface antigen (HBsAg) positive patients intended to undergo chemotherapy were randomized to receive either LAM 100 mg daily or ADF 10 mg daily. Anti-viral therapy was started 1 week prior to chemotherapy and until 6 months after completing chemotherapy. The primary outcome was HBV reactivation rate. All patients with viral breakthrough were screened for resistance mutations by direct sequencing. Seventy treatment-naïve patients were consecutively randomized 1:1 to LAM or ADF. The median baseline HBV DNA levels were similar (LAM 3.36 vs. ADF 3.17 log10 copies/mL, p = 0.860). The median duration was 8.3 months on LAM and 10.6 months on ADF (p = 0.220). HBV reactivation was observed in 13/35 (37.1%) on LAM compared with 10/35 (28.6%) on ADF (p = 0.611). The median time to HBV reactivation was 4.6 and 8.1 months, on LAM and ADF respectively. Among these 13 patients, 8/13 (61.5%) on LAM had developed drug resistance mutations but none on ADF had developed drug resistance mutations to ADF (p = 0.003). Both drugs w...Continue Reading

References

Apr 1, 1982·Annals of Internal Medicine·J H HoofnagleJ Costa
Jul 9, 1998·The New England Journal of Medicine·C L LaiD F Gray
Aug 24, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R LiangY L Kwong
Oct 21, 1999·The New England Journal of Medicine·J L DienstagN A Brown
Oct 26, 1999·Critical Reviews in Oncology/hematology·G K LauR Liang
Oct 24, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Tak Mao ChanStephen K n Ho
Feb 28, 2003·The New England Journal of Medicine·Stephanos J HadziyannisUNKNOWN Adefovir Dipivoxil 438 Study Group
Feb 28, 2003·The New England Journal of Medicine·Patrick MarcellinUNKNOWN Adefovir Dipivoxil 437 Study Group
May 30, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Ann-Lii ChengUNKNOWN Lymphoma Committee of Taiwan Cooperative Oncology Group
Sep 10, 2003·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Hiroaki NagamatsuMichio Sata
Jan 16, 2004·Gastroenterology·Anna S F LokMary Castiglia
Oct 16, 2004·Journal of Gastroenterology and Hepatology·Ting-Tsung ChangNancy Wy Leung
Jan 22, 2005·The New England Journal of Medicine·Francisco Pérez-RoldánMaría Concepción Villafáñez-García
Jul 1, 2005·The New England Journal of Medicine·Stephanos J HadziyannisUNKNOWN Adefovir Dipivoxil 438 Study Group
Aug 3, 2005·American Journal of Clinical Oncology·Winnie YeoPhilip J Johnson
Jan 28, 2006·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Winnie Yeo, Philip J Johnson
May 5, 2006·Seminars in Liver Disease·Chee-Kin Hui, George K K Lau
Jul 25, 2006·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Ayse L MindikogluEugene R Schiff
Nov 8, 2006·Gastroenterology·Stephanos J HadziyannisUNKNOWN Adefovir Dipivoxil 438 Study Group
Jan 30, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Anna S F Lok, Brian J McMahon
Mar 30, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jay H HoofnagleAnna S F Lok
Nov 6, 2007·Clinics in Liver Disease·Holbrook E KohrtEmmet B Keeffe
Feb 28, 2008·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Chiun HsuPei-Jer Chen
Dec 17, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Winnie YeoPaul K S Chan
Feb 12, 2009·Therapeutics and Clinical Risk Management·Hans Ludger Tillmann
Jun 1, 2008·Hepatology International·George K K Lau
Aug 29, 2009·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Anna S F Lok, Brian J McMahon
Jul 7, 2010·European Journal of Internal Medicine·Masaaki WatanabeWasaburo Koizumi

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Citations

Jun 14, 2016·Clinical and Molecular Hepatology·Venessa Pattullo
Jun 25, 2019·The Cochrane Database of Systematic Reviews·Ning LiangJian Ping Liu
May 26, 2020·Expert Review of Gastroenterology & Hepatology·Shang-Chin HuangJia-Horng Kao
Jul 9, 2016·European Journal of Gastroenterology & Hepatology·Jessica K DysonStuart McPherson
Jan 29, 2019·BioMed Research International·Lixia GuoXiaosong Li
Dec 8, 2015·World Journal of Gastroenterology : WJG·Sobia ManzoorJaved Ashraf

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