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Digestive Diseases and Sciences

, Volume 58, Issue 5, pp 1363–1370 | Cite as

The Efficacy of Adefovir Plus Entecavir Combination Therapy in Patients with Chronic Hepatitis B Refractory to Both Lamivudine and Adefovir

  • Yuri Cho
  • Dong Hyeon Lee
  • Kwang Hyun Chung
  • Eunhyo Jin
  • Jeong-Hoon Lee
  • Eun Ju Cho
  • Su Jong Yu
  • Jin Wook Kim
  • Sook Hyang Jeong
  • Jung-Hwan Yoon
  • Hyo-Suk Lee
  • Chung Yong Kim
  • Yoon Jun Kim
Original Article

Abstract

Background

The efficacy of adefovir (ADV) plus entecavir (ETV) combination in patients with chronic hepatitis B (CHB) who developed multidrug refractoriness had not been fully evaluated. We aimed to evaluate the efficacy of ADV plus ETV as compared to that of lamivudine (LAM) plus ADV in the patients with antiviral refractoriness to sequential LAM monotherapy and then ADV monotherapy.

Methods

Twenty-seven patients were treated with a combination of ADV plus ETV and 63 patients were treated with a combination of LAM plus ADV. The virological and biochemical parameters were compared between the two groups, retrospectively.

Results

Treatment with a combination of ADV plus ETV produced significantly superior virological response than that of a combination of LAM plus ADV. At 12 months, the HBV DNA declined more in the ADV plus ETV group than in the LAM plus ADV (−4.52 ± 1.956 vs. −2.65 ± 1.723 log10IU/mL; p = 0.001). The rate of a complete response at 12 months was greater in the ADV plus ETV group than that in the LAM plus ADV group (63.16 vs. 14.81 %, p < 0.001).

Conclusion

In the patients with CHB refractory to both LAM and ADV, the response to ADV plus ETV was significantly superior compared to that of the LAM plus ADV in suppressing HBV DNA. The result indicates that ADV plus ETV can be used as a bridging therapy in the patients with refractoriness to both LAM and ADV, especially in the areas where tenofovir is not yet available.

Keywords

Chronic hepatitis B Entecavir Adefovir Combination therapy Drug resistance 

Notes

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Yuri Cho
    • 1
  • Dong Hyeon Lee
    • 1
  • Kwang Hyun Chung
    • 1
  • Eunhyo Jin
    • 1
  • Jeong-Hoon Lee
    • 1
  • Eun Ju Cho
    • 1
  • Su Jong Yu
    • 1
  • Jin Wook Kim
    • 2
  • Sook Hyang Jeong
    • 2
  • Jung-Hwan Yoon
    • 1
  • Hyo-Suk Lee
    • 1
  • Chung Yong Kim
    • 1
  • Yoon Jun Kim
    • 1
  1. 1.Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineChongno-guRepublic of Korea
  2. 2.Department of Internal MedicineSeoul National University Bundang HospitalSeongnamRepublic of Korea

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