HBV : O-005 ; Is an adefovir plus entecavir combination therapy superior to adefovir plus lamivudine combination therapy in patients with chronic hepatitis B resistant to both lamivudine and adefovir? = HBV : O-005 ; Is an adefovir plus entecavir combination therapy superior to adefovir plus lamivudine combination therapy in patients with chronic hepatitis B resistant to both lamivudine and adefovir?

다국어 초록 (Multilingual Abstract)

Background: The efficacy of adefovir (ADV) plus entecavir (ETV) combination in patients with chronic hepatitis B (CHB) who developed multidrug resistance had not been fully evaluated. We aimed to evaluate the efficacy of ADV plus ETV as compared to that of LAM plus ADV in patients with antiviral resistance to both LAM and ADV. Methods: 27 patients were treated with a combination of ADV plus ETV and 63 patients were treated with a combination of LAM plus ADV. The virological and biochemical parameters were compared between the two groups. Results: Treatment with a combination of ADV plus ETV produced a significantly superior in virological response compared to that in the LAM plus ADV group during 12 months of therapy. At 12 months, the HBV DNA declined more in the ADV plus ETV than in the LAM plus ADV (-4.52 ± 1.956 vs. -2.65 ± 1.723 log10IU/mL; p = 0.001). The rate of a complete response at 12 months was greater in the ADV plus ETV than that in the LAM plus ADV (73.68% vs. 31.48%, p = 0.005). Conclusions: In patients with CHB resistant to both LAM and ADV, the response to ADV plus ETV was significantly superior compared to that of the LAM plus ADV for suppressing HBV DNA through 12 months. The result indicates that ADV plus ETV rather than LAM plus ADV might be used as a bridging therapy in patients with CHB resistant to both LAM and ADV, especially in areas where tenofovir is not available.