Management of Clevudine-Resistant Chronic Hepatitis B: A Multicenter Cohort Study
- Abstract
- BACKGROUND/AIMS: Data are lacking regarding the management of chronic hepatitis B (CHB) with resistance to clevudine (CLV). This study evaluated the efficacy of different rescue therapies for CLV-resistant CHB. METHODS: Patients with CLV-resistant CHB were enrolled in the cohort, and all patients developed virologic breakthrough during CLV therapy and had confirmed-genotypic resistance to CLV (rtM204I mutation) before enrollment. RESULTS: Of the 107 patients, 12 received adefovir (ADV), 21 received a CLV plus ADV combination (CLV+ADV), 34 received a lamivudine plus ADV combination (LAM+ADV), and 40 received entecavir (ETV) therapy for 48 weeks. The CLV+ADV group had the lowest hepatitis B virus (HBV) DNA level (p<0.0001) and showed the greatest reduction of HBV DNA levels from baseline compared to all other groups (p=0.004) at week 48. HBV DNA was undetectable (<70 IU/mL) in 0%, 57.1%, 21.2%, and 27.5% (p=0.003) of the patients in each group, respectively, at week 48. At the end of the study, the mean alanine transaminase (ALT) level, rate of ALT normalization, and rate of hepatitis B envelope antigen loss or seroconversion did not differ between groups. CONCLUSIONS: CLV+ADV combination therapy in patients with CLV-resistant CHB more effectively suppresses HBV replication than ETV, ADV, or LAM+ADV therapy.
- All Author(s)
- E. Y. Cho
; H. J. Yim
; Y. K. Jung
; S. J. Suh
; Y. S. Seo
; J. H. Kim
; H. S. Kim
; S. H. Lee
; S. H. Ahn
; J. I. Lee
; S. H. Jeong
; J. W. Kim
; J. W. Lee
; I. H. Kim
; S. J. Park
; J. M. Lee
; S. G. Hwang
- Issued Date
- 2017
- Type
- Article
- Keyword
- Adenine/*analogs & derivatives/therapeutic use
Adult
Aged
Antiviral Agents/*therapeutic use
Arabinofuranosyluracil/*analogs & derivatives/therapeutic use
Cohort Studies
DNA, Viral/blood
Disease Management
Drug Resistance, Viral/genetics
Drug Therapy, Combination
Female
Genotype
Guanine/*analogs & derivatives/therapeutic use
Hepatitis B virus/genetics
Hepatitis B, Chronic/blood/*drug therapy/virology
Humans
Lamivudine/*therapeutic use
Male
Middle Aged
Organophosphonates/*therapeutic use
Viral Load
Clevudine
Hepatitis B, chronic
Resistance
Therapy
- Publisher
- 대한소화기학회
- ISSN
- 1976-2283
- Citation Title
- Gut and Liver
- Citation Volume
- 11
- Citation Number
- 1
- Citation Start Page
- 129
- Citation End Page
- 135
- Language(ISO)
- eng
- DOI
- 10.5009/gnl15597
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2974
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