In:
Journal of Medical Virology, Wiley, Vol. 88, No. 6 ( 2016-06), p. 1027-1034
Abstract:
Most guidelines suggest combination therapy including nucleoside and nucleotide analogues for the treatment of chronic hepatitis B (CHB) with multidrug resistance (MD‐R). However, long‐term combination treatment can evoke high costs and safety problems. Therefore, we investigated the efficacy of tenofovir disoproxil fumarate (TDF) mono‐rescue therapy for viral suppression in patients with CHB exhibiting MD‐R. We reviewed patients with CHB exhibiting antiviral drug resistance treated by TDF mono‐rescue therapy from December 2012 to June 2014. The patients were categorized into three groups: lamivudine‐resistance (LAM‐R) group (n = 290), and LAM‐R + adefovir‐resistance (ADV‐R) group (n = 43), and LAM‐R + entecavir‐resistance (ETV‐R) group (n = 113). We compared the virologic response rate according to the multiplicity of resistance and investigated the predictive factors of a virologic response. For a median of 15 months (range, 6–24 months) of TDF mono‐rescue therapy, the cumulative virologic response rates were 82.8, 81.4, and 84.1% in the LAM‐R, LAM‐R + ADV‐R, and LAM‐R + ETV‐R groups, respectively ( P = 0.239). Multivariate analysis revealed that multiplicity of resistance did not influence the achievement of a virologic response ( P = 0.218). However, the baseline HBV DNA level significantly influenced the achievement of a virologic response for the treatment of CHB with MD‐R ( P 〈 0.001). TDF mono‐rescue therapy is an appropriate treatment for CHB with MD‐R, and the baseline HBV DNA level is a significant predictive factor for a virologic response. These factors should be considered before treating CHB with MD‐R. J. Med. Virol. 88:1027–1034, 2016 . © 2015 Wiley Periodicals, Inc.
Type of Medium:
Online Resource
ISSN:
0146-6615
,
1096-9071
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
752392-0
detail.hit.zdb_id:
1475090-9
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