Adefovir Alone or in Combination with Ongoing Lamivudine
in Patients with Decompensated Liver Disease and Lamivudine-resistant
Hepatitis B Virus
The purpose of this prospective study was
to evaluate the efficacy and safety of adefovir dipivoxil (Hepsera) with or without ongoing lamivudine (Epivir-HBV) in decompensated
lamivudine-resistant chronic hepatitis B patients.
Forty-six
hepatitis B e antigen
(HBeAg)-positive patients
with
decompensated liver function and lamivudine-resistant
hepatitis B virus (HBV) received adefovir dipivoxil monotherapy (n=18) or combination
therapy with ongoing lamivudine (n=28), according to their own preference.
Results
After 24 weeks of treatment, 83% of monotherapy
and 86% of combination therapy showed serum HBV DNA below
detection limit (<0.5 pg/mL).
Alanine aminotransferase (ALT) normalized in 78% and 82%, respectively.
Median
Child-Pugh-Turcotte (CPT) score
or Model for End-Stage Liver Disease (MELD) score reduced
significantly by 3 or 5 point in monotherapy and 2 or 2 point in combination therapy, respectively.
There
were no significant differences in rate of undetectable
serum HBV DNA, median change of ALT and median reduction
of CPT or MELD scores between the two groups.
The
authors conclude, “Both adefovir dipivoxil monotherapy and combination therapy with ongoing lamivudine result in comparable virologic,
biochemical, and clinical improvements in HBeAg-positive
patients with decompensated liver
function and lamivudine-resistant HBV.”
“Combination
with lamivudine showed no additional benefit over monotherapy during 24 weeks of treatment in these patients.”
Department of Internal Medicine, Asian Medical
Center, University of Ulsan College
of Medicine, Seoul, Korea.
10/19/04
Reference
K M Kim and others. Adefovir Dipivoxil Alone or in Combination with Ongoing Lamivudine in Patients with Decompensated
Liver Disease and Lamivudine-resistant
Hepatitis B Virus. Journal of Korean Medical Science 20(5):821-828. October 2005.
Related articles
Adefovir
dipivoxil added to ongoing lamivudine
in chronic hepatitis B with YMDD mutant hepatitis B virus.
Adefovir dipivoxil alone
or in combination with lamivudine
in patients with lamivudine-resistant chronic hepatitis B
