Adefovir-Telbivudine Combination Effective in Lamivudine-Resistant Patients With several antivirals now available, researchers are trying to determine which combination will be most effective in patients. Each antiviral targets a different region of the virus, and combinations may be especially effective in people who have developed resistance to some antivirals, such as lamivudine (Epivir-HBV), which has a high rate of resistance.
In a recent study reported in the journal Hepatology International, researchers studied the effectiveness of the antiviral adefovir (Hepsera) used alone or in combination with telbivudine (Tyzeka) over 48 weeks in patients who had developed resistance to lamivudine.
Declines in HBV DNA were greater in the group received the antiviral combination (viral load drops were 7.4-fold in the combination group, compared with 4.9-fold in the group treated with only adefovir.) Additionally, 38.5% of the group receiving both antivirals achieved undetectable HBV DNA compared to the group treat with only adefovir.
Two adefovir-only patients developed a viral breakthrough due to the drug’s ineffectiveness. None of the combination-treated patients experienced a resurgence of viral load.
HBeAg loss occurred in 3 patients in the combination group and one patient in the adefovir group.
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