Switching patients with lamivudine resistant chronic hepatitis B virus from tenofovir to adefovir results in less potent HBV-DNA suppression

Journal of Viral Hepatitis
W F LeemansR A de Man

Abstract

The nucleotide analogues, tenofovir disoproxil fumarate and adefovir dipivoxil, inhibit viral replication and are both effective against the hepatitis B virus (HBV). In our department, tenofovir was prescribed in addition to lamivudine for the treatment of lamivudine resistant chronic hepatitis B. After registration of adefovir, 10 patients were switched to adefovir monotherapy. We studied changes in HBV-DNA and alanine aminotransferase (ALT) in these patients. The median treatment duration with tenofovir was 78 weeks resulting in a median viral load reduction of 5.4 (range 6.8-2.3) log(10) copies/mL compared to baseline (P = 0.005). Two patients had an increase >1 log(10) copies/mL during tenofovir treatment. After the switch to adefovir, six out of 10 patients had an HBV-DNA >4 log(10) copies/mL and the median HBV-DNA increased from 2.8 to 4.5 log(10) copies/mL (P = 0.017). The factors associated with relapse were HBV-DNA PCR positivity at the time of switch and genotype B or D. ALT levels at the beginning of tenofovir treatment also might be a factor. Retreatment with tenofovir (n = 3) resulted in a rapid decline in HBV-DNA. Tenofovir is a potent antiviral drug. Switching to adefovir resulted in viral relapse in 60% of patie...Continue Reading

References

Jul 9, 1998·The New England Journal of Medicine·C L LaiD F Gray
Oct 21, 1999·The New England Journal of Medicine·J L DienstagN A Brown
Mar 7, 2001·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·L J StuyverR F Schinazi
Jul 27, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Florian van BömmelThomas Berg
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
Sep 17, 2004·The New England Journal of Medicine·Patrick MarcellinUNKNOWN Peginterferon Alfa-2a HBeAg-Negative Chronic Hepatitis B Study Group
Sep 25, 2004·Antimicrobial Agents and Chemotherapy·J Andy Tincu, Steven W Taylor
Oct 16, 2004·Journal of Gastroenterology and Hepatology·Ting-Tsung ChangNancy Wy Leung
Nov 27, 2004·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Florian van BömmelThomas Berg
Jan 11, 2005·Lancet·Harry L A JanssenUNKNOWN Rotterdam Foundation for Liver Research
Jun 18, 2005·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Florian van Bömmel, Thomas Berg
Dec 13, 2005·Journal of Hepatology·Scott K FungAnna S F Lok
Jan 19, 2006·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·T E M S de Vries-SluijsM E van der Ende
Feb 18, 2006·Scandinavian Journal of Gastroenterology·Oliver SchildgenWolfram H Gerlich
Apr 20, 2006·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Etsuro OritoMasashi Mizokami
Apr 28, 2006·The New England Journal of Medicine·Oliver SchildgenWolfram H Gerlich
Jun 28, 2006·Antimicrobial Agents and Chemotherapy·William E DelaneyMichael D Miller
Jul 21, 2006·The New England Journal of Medicine·Ting-Tsung Chang, Ching-Lung Lai

❮ Previous
Next ❯

Citations

Jan 1, 2009·Infection and Drug Resistance·Jurriën Gp Reijnders, Harry LA Janssen
May 14, 2009·Therapeutics and Clinical Risk Management·Laura ReynaudGuglielmo Borgia
Jan 18, 2013·World Journal of Gastroenterology : WJG·Zhuo-Lun SongHong Zheng

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antivirals

Antivirals are medications that are used specifically for treating viral infections. Discover the latest research on antivirals here.

Antimicrobial Resistance (ASM)

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Antimicrobial Resistance

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Antivirals (ASM)

Antivirals are medications that are used specifically for treating viral infections. Discover the latest research on antivirals here.