http://www.ncbi.nlm.nih.gov/pubmed/22688509
J Pediatr Gastroenterol Nutr. 2012 Dec;55(6):648-52. doi: 10.1097/MPG.0b013e318262a737.

Virologic Responses to Add-on Adefovir Dipivoxil Treatment Versus Entecavir Monotherapy in Children With Lamivudine-resistant Chronic Hepatitis B.

Chu M, Cho SM, Choe BH, Cho MH, Kwon S, Lee WK.

Source: *Department of Pediatrics †Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Abstract

PURPOSE: The aim of the study was to compare the virologic response to adefovir (ADV) add-on therapy with switching to entecavir (ETV) monotherapy in children and adolescents with chronic hepatitis B (CHB) who have developed lamivudine (LAM) resistance during LAM treatment.

METHODS: Twenty-seven consecutive patients with CHB who had developed LAM resistance during LAM treatment were included. Of these 27 patients, 8 patients were treated with the addition of ADV to ongoing LAM and 8 patients were treated by switching to ETV monotherapy and each of these 16 patients were compared with the 11 patients who were treated by switching to ADV alone, as a historical control. Therapeutic responses to treatment were evaluated at 12, 24, 36, and 48 weeks from the initiation of therapy by measuring the decrement of hepatitis B virus (HBV)-DNA titers.

RESULTS: The therapeutic period for HBV-DNA titer decrement (>2 log10 IU/mL) was significantly shorter in both the LAM+ADV group and the ETV group than in the ADV group (P = 0.008); however, there was no significant difference between the LAM+ADV group and the ETV group. The rate of virologic response, defined as decrement in HBV-DNA titer to undetectable levels at 24 weeks, was significantly higher in both the LAM+ADV group and the ETV group than in the ADV group (P = 0.029).

CONCLUSIONS: Both the LAM+ADV combination therapy and ETV monotherapy exhibited significantly more effective virologic responses compared to the ADV monotherapy in children and adolescents with LAM-resistant CHB, although there was no significant difference between the LAM+ADV group and the ETV group.

PMID: 22688509 [PubMed - in process]