Tenofovir-based rescue therapy for chronic hepatitis B patients who had failed treatment with lamivudine, adefovir, and entecavir

Background and Aim In the past decade, many chronic hepatitis B (CHB) patients have undergone sequential treatment with lamivudine (LAM), adefovir (ADV), and entecavir (ETV) to manage antiviral resistance or insufficient suppression of HBV‐DNA. Very limited data are available on the efficacy of teno...

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Bibliographic Details
Published in:Journal of gastroenterology and hepatology 2015-10, Vol.30 (10), p.1514-1521
Main Authors: Kim, Byung Gyu, Jung, Seok Won, Kim, Eun Hye, Kim, Jae Hee, Park, Ju Hwan, Sung, Shi Jung, Park, Bo Ryung, Kim, Min-Ho, Kim, Chang Jae, Lee, Byung Uk, Park, Jae Ho, Jeong, In Du, Bang, Sung-Jo, Shin, Jung Woo, Park, Neung Hwa
Format: Article
Language:English
Subjects:
Adenine - analogs & derivatives
Adult
Antiviral Agents - administration & dosage
chronic hepatitis B
DNA, Viral - blood
Drug Resistance, Multiple
Drug Therapy, Combination
Female
Guanine - administration & dosage
Guanine - analogs & derivatives
Hepatitis B virus - genetics
Hepatitis B, Chronic - drug therapy
Hepatitis B, Chronic - virology
Humans
Lamivudine - administration & dosage
Male
Middle Aged
multidrug resistance
Multivariate Analysis
Organophosphonates
tenofovir
Tenofovir - administration & dosage
Treatment Failure
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Summary:Background and Aim In the past decade, many chronic hepatitis B (CHB) patients have undergone sequential treatment with lamivudine (LAM), adefovir (ADV), and entecavir (ETV) to manage antiviral resistance or insufficient suppression of HBV‐DNA. Very limited data are available on the efficacy of tenofovir (TDF) rescue regimens in patients with multidrug resistance (MDR). Methods We investigated the antiviral efficacy of TDF/LAM combination therapy versus TDF/ETV combination therapy in 52 patients who failed three previous antiviral therapies. Results The study subjects were treated with TDF/LAM combination therapy (n = 25) or TDF/ETV combination therapy (n = 27) for more than six months. Virologic response (VR) occurred in 39 (75%) patients (19 patients belonged to the TDF/LAM group and 20 patients belonged to the TDF/ETV group). The VR rates were not different between the TDF/LAM and TDF/ETV groups (56.0% vs 51.9% at month 12, and 72.0% vs 78.8% at month 18; log rank P = 0.515). In addition, treatment efficacy of TDF/LAM combination or TDF/ETV combination was not statistically different according to types of MDR. In multivariate analysis, absolute HBV‐DNA level at the start of TDF rescue treatment (P 
ISSN:0815-9319
1440-1746
DOI:10.1111/jgh.12993