Background/Aims
We investigated the efficacy of entecavir in lamivudine-experienced and -naïve patients
with persistently high HBV DNA during adefovir treatment.
Methods
Fourteen chronic hepatitis B patients (57% lamivudine-experienced) with a viral load
above 5log10 copies/mL after 12 months of adefovir therapy and thereafter were treated with entecavir 1 mg daily.
Results
During a median follow-up of 15 months (range: 8–23 months) one of six lamivudine–naïve and none of the eight lamivudine-experienced patients
achieved undetectable HBV DNA (<373 copies/mL). HBeAg loss occurred in none of the subjects. Two lamivudine-experienced
patients demonstrated the rtM204I mutation; no other entecavir-resistant substitutions
were detected (rtI169, rtT184, rtS202, and rtM250). Two of three patients with genotypic
adefovir resistance at baseline demonstrated a rapid virologic response to entecavir,
but undetectable HBV DNA was not achieved. To attain a better antiviral response the
dosage of entecavir was increased to 2 mg daily in two patients, resulting in further viral load decline for both of them.
Conclusions
Entecavir monotherapy dosed at 1 mg resulted in a slow reduction of viral load in both lamivudine-experienced and -naïve
patients with persistently high HBV DNA during adefovir therapy. Increasing the dosage
of entecavir led to further HBV DNA decline.
Abbreviations:
HBV (hepatitis B virus), LAM (lamivudine), ADV (adefovir dipivoxil), TDF (tenofovir disoproxil fumarate), ETV (entecavir)Keywords
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Article info
Publication history
Published online: December 29, 2008
Accepted:
October 22,
2008
Received in revised form:
October 8,
2008
Received:
June 11,
2008
Associate Editor: F. ZoulimFootnotes
☆H.L.A. Janssen received grants from and is consultant for: Bristol Myers Squibb, Gilead, Novartis, Roche and Schering-Plough. R.A. de Man received an unrestricted research grant from Biotest, clinical trial support from Bristol Myers Squibb and Gilead, and is a member of the Data safety monitoring board of Novartis. The other authors have nothing to declare.
Identification
Copyright
© 2008 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
