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

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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.

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Authors and Affiliations

  1. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Republic of Korea

    Yuri Cho, Dong Hyeon Lee, Kwang Hyun Chung, Eunhyo Jin, Jeong-Hoon Lee, Eun Ju Cho, Su Jong Yu, Jung-Hwan Yoon, Hyo-Suk Lee, Chung Yong Kim & Yoon Jun Kim

  2. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea

    Jin Wook Kim & Sook Hyang Jeong

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  1. Yuri Cho
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  2. Dong Hyeon Lee
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  13. Yoon Jun Kim
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Correspondence to Yoon Jun Kim.

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Cho, Y., Lee, D.H., Chung, K.H. et al. The Efficacy of Adefovir Plus Entecavir Combination Therapy in Patients with Chronic Hepatitis B Refractory to Both Lamivudine and Adefovir. Dig Dis Sci 58, 1363–1370 (2013). https://doi.org/10.1007/s10620-012-2480-1

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  • DOI: https://doi.org/10.1007/s10620-012-2480-1

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