特纳福韦比阿地福韦治疗拉米耐药更有效 (hepwatch 2005-2-7)

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LAMIVUDINE-RESISTANT HBV

Comparison of adefovir and tenofovir. Florian van Bommel et al. analyzed treatment of 53 consecutive patients with lamivudine-resistant HBV infection with either adefovir (n=18) for 60 to 80 weeks or tenofovir (n=35) for 72 to 130 weeks. Of the tenofovir-treated patients, 21 were coinfected with HIV. Tenofovir therapy was associated with an early suppression of HBV DNA, resulting in a reduction of HBV DNA levels at week 48 to <105 copies/mL in 100% of tenofovir-treated patients, vs. 44% of adefovir-treated patients. Both agents were well tolerated, with no evidence of phenotypic resistance. These data suggest that tenofovir may be a potentially effective alternative treatment for patients with lamivudine-resistant HBV infection. Controlled trials with larger numbers of patients are warranted. (van Bommel F, et al. Hepatology 2004;40:1421-1425)