• 作者：Emilio Suá ; rez^a ; ^{em121154@terra.es} ; Ana Gila^b ; Blanca Figueruela^a ; Natalia Chueca^c ; Pilar Muñ ; oz Rueda^b ; Beatriz Puche^d ; Enrique Fraga^e ; Federico Garcí ; a^c ; Juan Manuel Martí ; n^f ; Raú ; l J. Andrade^g ; Carmen Nogales^d ; Manuel Romero-Gó ; mez^a ; Javier Salmeró ; n^b
• 关键词：Hepatitis B cr&oacute ; nica HBeAg negativo ; Adefovir dipivoxil ; Lamivudina ; Resistencias ; Tratamiento antiviral
• 刊名：Gastroenterolog铆a y Hepatolog铆a
• 出版年：2011
• 期刊代码：pca167_02105705
• 类别：med
• 出版时间：February 2011
• 卷：34
• 期：2
• 页码：69-74
• 文件大小：211 K

Background and objective

Adefovir dipivoxil monotherapy in lamivudine-resistant patients is associated with more frequent development of resistance than in na茂ve patients. The virological response during treatment predicts the risk of developing resistance. The aims of this study were to assess the efficacy of adefovir dipivoxil treatment in na茂ve and lamivudine-resistant patients and to determine whether virological response predicts the development of adefovir resistance.

Patients and method

This study included 82 patients with HBeAg-negative chronic hepatitis B (CHB) who received adefovir dipivoxil therapy. During active treatment, HBV-DNA values were determined by polymerase chain reaction; in addition, the presence of adefovir resistance-associated mutations was studied in cases of virological breakthrough.

Results

Virological response at 12 and 24 months was 59%and 73%in naive patients compared with 40%and 67%in lamivudine-resistant patients, whereas virological breakthrough at 24 months was 9.5%in na茂ve patients compared with 20%in lamivudine-resistant patients. A small percentage (4%) of patients with virological response at 12 months showed virological breakthrough between 12 and 40 months versus 29.4%of patients without virological response (P = .03). In lamivudine-resistant patients, virological response at 12 months was not a predictive factor for the development of virological breakthrough.

Conclusions

Adefovir dipivoxil monotherapy in lamivudine-resistant patients is associated with an increased tendency to develop virological breakthrough, which cannot be predicted by virological response at 12 months of treatment. In naive patients, an undetectable viral load at 12 months of treatment ensures the absence of virological breakthrough at 40 months of treatment.