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J Hepatol. 2009 Apr;50(4):674-83. doi: 10.1016/j.jhep.2008.10.033. Epub 2008 Dec 29.

Entecavir shows limited efficacy in HBeAg-positive hepatitis B patients with a partial virologic response to adefovir therapy.

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  • 1Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, 's Gravendijkwal 230, Room Ha 204, 3015 CE Rotterdam, The Netherlands.

Abstract

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 5log(10)copies/mL after 12months of adefovir therapy and thereafter were treated with entecavir 1mg daily.

RESULTS:

During a median follow-up of 15months (range: 8-23months) one of six lamivudine-naïve and none of the eight lamivudine-experienced patients achieved undetectable HBV DNA (<373copies/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 2mg daily in two patients, resulting in further viral load decline for both of them.

CONCLUSIONS:

Entecavir monotherapy dosed at 1mg 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.

PMID:
19231002
[PubMed - indexed for MEDLINE]
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