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本帖最后由 StephenW 于 2014-10-23 11:14 编辑
1880Tenofovir Mono-rescue therapy vs. Tenofovir plus Ente-cavir combination-rescue therapy in chronic hepatitis B with lamivudine and entecavir resistance: a Korean multi-center study
Sangheun Lee1,2, Jun Yong Park1, Hana Park3, Moon Young Kim4, Sang Hoon Ahn1, Pumsoo Kim2, Kwang-Hyub Han1;1Department of Internal Medicine, Yonsei Universtiy College of Medicine, Seoul, Republic of Korea; 2Department of Internal medicine, International St. Mary's Hospital, Incheon Metropolitan city, Republic of Korea; 3Department of Internal medicine, CHA university, Seongnam-si, Republic of Korea; 4Department of Internal medicine, Yonsei university Wonju College of Medicine, Wonju, Republic of Korea
Background: Tenofovir disoproxil fumarate (TDF) has demonstrated high antiviral efficacy of lamivudine - resistant (LAM-R) chronic hepatitis B (CHB) virus infection. However, it is rarely studied how to manage CHB with LAM-R and entecavir resistant (ETV-R). We compared the viral suppressive efficacy between TDF mono-rescue therapy and TDF plus ETV combination-rescue therapy in CHB patients with LAM-R and ETV-R. Methods: In a multi-center cohort study, 117 CHB patients with experience of LAM-R and ETV-R during previous antiviral therapy were investigated. 65 patients were treated with TDF mono-rescue therapy (TDF group) and 52 were treated with TDF plus ETV combination-rescue therapy (TDF + ETV group), for at least 3 months. The primary end point was viral response defined as the proportion with HBV DNA < 20 IU/mL. Results: There were no significant differences between the two groups in demographic characteristics. During a median follow-up of 9 months (3-12), 87/117 (74.4%) patients achieved virologic response. TDF group and TDF + ETV group achieved viral response with 69.9% vs. 69.4% at months 3 (p=0.977), 58.8% vs. 79.5% at months 6 (p=0.030), 72.7% vs. 89.2% at months 9 (p=0.077), and 64.7% and 96.0% at months 12 (p=0.008), respectively. Mean log10 HBV DNA continued to fall throughout from 3.3 to 1.5 in TDF group and 3.8 to 1.4 in TDF plus ETV combination-rescue therapy group during the 1year treatment. Both treatments were generally well tolerated. Conclusion: In CHB patients with experience of LAM-R and ETV-R, TDF plus ETV combination-rescue therapy was superior to TDF mono-rescue therapy group. However, further follow-up are required for the evaluation of efficacy between two groups.
Disclosures:
The following people have nothing to disclose: Sangheun Lee, Jun Yong Park, Hana Park, Moon Young Kim, Sang Hoon Ahn, Pumsoo Kim, Kwang-Hyub Han
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