AASLD2014:替诺福韦单声道抢救治疗与加替诺福韦联合恩替卡韦

StephenW

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

StephenW

1880
替诺福韦单声道抢救治疗与加替诺福韦联合恩替卡韦，抢救治疗与拉米夫定和恩替卡韦耐药的慢性乙型肝炎：韩国多中心研究
Sangheun Lee1,2，君永Park1，花Park3，月亮年轻Kim4，桑勋Ahn1，Pumsoo Kim2，刘广Hyub涵1;
教研室内科，医学韩国延世Universtiy学院，首尔，韩国的;内科教研室，国际圣玛丽医院，仁川广域市，韩国;国内大学医学系，查大学，城南市，大韩民国; 4Department内科，医学韩国延世大学原州大学，原州，大韩民国

背景：富马酸替诺福韦酯（TDF）已经证明拉米夫定高抗病毒疗效 - 耐药（LAM-R）的慢性乙型肝炎（CHB）病毒感染。然而，很少研究了如何用LAM-R和恩替卡韦耐药（ETV-R）的管理CHB。我们比较了TDF单一抢救治疗和TDF以及恩替卡韦联合救援治疗的病毒抑制效果慢性乙型肝炎患者LAM-R和ETV-R。方法：采用多中心队列研究，117例慢性乙型肝炎患者与LAM-R和ETV-R时之前的抗病毒治疗的经验进行了调查。 65例患者采用TDF单抢救治疗（TDF组）和52治疗TDF以及恩替卡韦联合救援治疗（TDF+恩替卡韦组）进行治疗，至少3个月。主要终点是定义为HBV DNA<20 IU/ mL的比例病毒学应答。结果：两组的人口学特征，两组间无显著差异。中位随访时间为9个月（3-12），一百一十七分之八十七（74.4％）患者获得病毒学应答。有69.9％和69.4％，至3个月（P =0.977），58.8％和79.5％，至个月，9个月，华盈集团和TDF+恩替卡韦组达到病毒学应答6（P = 0.030），72.7％和89.2％ （p值=0.077），和64.7％，并在几个月12（p值=0.008），分别为96.0％。意思是LOG10 HBV-DNA持续在1年整个治疗由3.3下降到1.5 TDF组和3.8在TDF以及恩替卡韦联合救援治疗组1.4。两种治疗一般耐受性良好。结论：慢性乙型肝炎患者LAM-R和ETV-R，TDF以及恩替卡韦联合救援治疗的经验优于TDF单抢救治疗组。然而，进一步的后续所需的疗效，两组之间的评价。

披露：

下面的人都没有透露：Sangheun李雍俊园，花公园，月亮扬金，桑勋安，Pumsoo金，刘广Hyub汉