Factors affecting initial virologic response and emergence of resistant mutants after adefovir treatment in lamivudine resistant chronic hepatitis B patients

BACKGROUNDS: Adefovir dipivoxil effectively inhibits both wild-type and lamivudine-resistant hepatitis B virus replication. The development of adefovir resistance is delayed and infrequent compared with lamivudine resistance. The aim of this study was to characterize the serologic, biochemical and virologic response to adefovir, and to explore the factors affecting initial virologic response(IVR) and adefovir resistance in lamivudine resistant HBV infected patients. MATERIALS AND METHODS: Between March 2004 and December 2006, 76 patients with lamivudine-resistance who had received adefovir for more than 12 months were included. Assay of adefovir-resistant mutant was performed at 6 months and 12 months during adefovir administration. Restriction fragment mass polymorphism analysis was used for YMDD mutant and adefovir mutant detection. RESULTS: After adefovir administration, IVR was observed in 31% patients with lamivudine resistance. Factors associated with IVR were HBeAg negativity (P=0.04) and presence of liver cirrhosis (P =0.04). Age, sex, pretreatment AST/ALT, pretreatment HBV DNA levels, presence of precore mutation and types of YMDD mutants were not related to IVR duringadefovir treatment. The prevalence of adefovir resistance was 5% at 6 months and 13% at 12 months after therapy. Mixed infection of precore mutant was a risk factors for emergence of adefovir resistance (P=0.01). CONCLUSIONS: Patients having HBeAg negativity and liver cirrhosis were more likely to achieve IVR after adefovir therapy in lamivudine-resistant HBV patients. Adefovir resistance was associated with mixed infection of precore mutant

Author dc:creator

• 조, 진희

Contributors dc:contributor

• 조, 성원
• 대학원 의학과
• 104857

• 아데포비어
• B형 간염
• 라미부딘
• 약제 내성
• adefovir
• hepatitisB
• lamivudine
• drug resistance

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000006674
000000006674

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1838