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Impact of prior lamivudine use on the antiviral efficacy and development of resistance to entecavir in chronic hepatitis B patients.

Hwang JA, Kim KB, Yang MJ, Lim SG, Hwang JC, Cheong JY, Cho SW, Kim SS - Clin Mol Hepatol (2015)

Bottom Line: In subgroup analysis, after excluding the 10 patients who were refractory to LAM therapy, the cumulative probability of ETV resistance did not differ significantly between the two groups (P=0.149).However, prior LAM use without refractoriness did not affect the development of ETV resistance.The serum hepatitis B virus DNA level at month 12 was a major predictor for the development of ETV resistance.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT

Background/aims: To determine the efficacies of entecavir (ETV) in nucleos(t)ide analogue (NA)-naïve chronic hepatitis B (CHB) patients and in those with prior lamivudine (LAM) use who did not develop resistance.

Methods: We retrospectively enrolled 337 patients with CHB who were treated with ETV (0.5 mg daily) for at least 30 months. The study included 270 (80.1%) NA-naïve patients and 67 (19.9%) LAM-use patients. Ten of the LAM-use patients were refractory to LAM therapy without developing resistance.

Results: Genotypic resistance to ETV developed more frequently in the LAM-use group (13.1%) than in the NA-naïve group (2.6%) at 60 months (P=0.009). In subgroup analysis, after excluding the 10 patients who were refractory to LAM therapy, the cumulative probability of ETV resistance did not differ significantly between the two groups (P=0.149). Prior LAM refractoriness and a higher hepatitis B virus DNA level at month 12 were independent predictive factors for the development of ETV resistance.

Conclusions: ETV resistance developed more frequently in LAM-use patients with CHB. However, prior LAM use without refractoriness did not affect the development of ETV resistance. The serum hepatitis B virus DNA level at month 12 was a major predictor for the development of ETV resistance.

No MeSH data available.


Related in: MedlinePlus

Antiviral efficacies of entecavir (ETV) treatment according to prior lamivudine use in the two study groups. (A) Kaplan-Meier curve for the cumulative probabilities of achieving virologic response. (B) Comparison of the hepatitis B e antigen (HBeAg) loss probabilities during ETV therapy. (C) Comparison of the HBeAg seroconversion probabilities during ETV therapy. (D) Comparison of the ALT normalization probabilities during ETV therapy. LAM, lamivudine; NA, nucleos(t)ide analogue; ALT, alanine aminotransferase.
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Figure 2: Antiviral efficacies of entecavir (ETV) treatment according to prior lamivudine use in the two study groups. (A) Kaplan-Meier curve for the cumulative probabilities of achieving virologic response. (B) Comparison of the hepatitis B e antigen (HBeAg) loss probabilities during ETV therapy. (C) Comparison of the HBeAg seroconversion probabilities during ETV therapy. (D) Comparison of the ALT normalization probabilities during ETV therapy. LAM, lamivudine; NA, nucleos(t)ide analogue; ALT, alanine aminotransferase.

Mentions: Antiviral efficacy of ETV is summarized in Figure 2. The cumulative probabilities of VR are shown in Figure 2A. The VR rates at months 12, 24, 36, 48, and 60 were 81.9%, 93.0%, 95.2%, 97.0%, and 97.0% in the NA-naive group and 79.1%, 86.6%, 92.5%, 94.0%, and 94.0% in the LAM-use group, respectively. There was no statistically significant difference between the two groups (log rank P=0.257).


Impact of prior lamivudine use on the antiviral efficacy and development of resistance to entecavir in chronic hepatitis B patients.

Hwang JA, Kim KB, Yang MJ, Lim SG, Hwang JC, Cheong JY, Cho SW, Kim SS - Clin Mol Hepatol (2015)

Antiviral efficacies of entecavir (ETV) treatment according to prior lamivudine use in the two study groups. (A) Kaplan-Meier curve for the cumulative probabilities of achieving virologic response. (B) Comparison of the hepatitis B e antigen (HBeAg) loss probabilities during ETV therapy. (C) Comparison of the HBeAg seroconversion probabilities during ETV therapy. (D) Comparison of the ALT normalization probabilities during ETV therapy. LAM, lamivudine; NA, nucleos(t)ide analogue; ALT, alanine aminotransferase.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493356&req=5

Figure 2: Antiviral efficacies of entecavir (ETV) treatment according to prior lamivudine use in the two study groups. (A) Kaplan-Meier curve for the cumulative probabilities of achieving virologic response. (B) Comparison of the hepatitis B e antigen (HBeAg) loss probabilities during ETV therapy. (C) Comparison of the HBeAg seroconversion probabilities during ETV therapy. (D) Comparison of the ALT normalization probabilities during ETV therapy. LAM, lamivudine; NA, nucleos(t)ide analogue; ALT, alanine aminotransferase.
Mentions: Antiviral efficacy of ETV is summarized in Figure 2. The cumulative probabilities of VR are shown in Figure 2A. The VR rates at months 12, 24, 36, 48, and 60 were 81.9%, 93.0%, 95.2%, 97.0%, and 97.0% in the NA-naive group and 79.1%, 86.6%, 92.5%, 94.0%, and 94.0% in the LAM-use group, respectively. There was no statistically significant difference between the two groups (log rank P=0.257).

Bottom Line: In subgroup analysis, after excluding the 10 patients who were refractory to LAM therapy, the cumulative probability of ETV resistance did not differ significantly between the two groups (P=0.149).However, prior LAM use without refractoriness did not affect the development of ETV resistance.The serum hepatitis B virus DNA level at month 12 was a major predictor for the development of ETV resistance.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT

Background/aims: To determine the efficacies of entecavir (ETV) in nucleos(t)ide analogue (NA)-naïve chronic hepatitis B (CHB) patients and in those with prior lamivudine (LAM) use who did not develop resistance.

Methods: We retrospectively enrolled 337 patients with CHB who were treated with ETV (0.5 mg daily) for at least 30 months. The study included 270 (80.1%) NA-naïve patients and 67 (19.9%) LAM-use patients. Ten of the LAM-use patients were refractory to LAM therapy without developing resistance.

Results: Genotypic resistance to ETV developed more frequently in the LAM-use group (13.1%) than in the NA-naïve group (2.6%) at 60 months (P=0.009). In subgroup analysis, after excluding the 10 patients who were refractory to LAM therapy, the cumulative probability of ETV resistance did not differ significantly between the two groups (P=0.149). Prior LAM refractoriness and a higher hepatitis B virus DNA level at month 12 were independent predictive factors for the development of ETV resistance.

Conclusions: ETV resistance developed more frequently in LAM-use patients with CHB. However, prior LAM use without refractoriness did not affect the development of ETV resistance. The serum hepatitis B virus DNA level at month 12 was a major predictor for the development of ETV resistance.

No MeSH data available.


Related in: MedlinePlus