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Increased risk of adefovir resistance in patients with lamivudine-resistant chronic hepatitis B after 48 weeks of adefovir dipivoxil monotherapy

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dc.contributor.authorLee, Yoon-Seon-
dc.contributor.authorSuh, Dong Jin-
dc.contributor.authorLim, Young-Suk-
dc.contributor.authorJung, Suk Won-
dc.contributor.authorKim, Kang Mo-
dc.contributor.authorLee, Han Chu-
dc.contributor.authorChung, Young-Hwa-
dc.contributor.authorLee, Yung Sang-
dc.contributor.authorYoo, Wangdon-
dc.contributor.authorKim, Soo-Ok-
dc.date.accessioned2010-01-29T07:56:07Z-
dc.date.available2010-01-29T07:56:07Z-
dc.date.issued2006-05-27-
dc.identifier.citationHepatology. 2006 Jun;43(6):1385-91.en
dc.identifier.issn0270-9139 (Print)-
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16729316-
dc.identifier.urihttp://dx.dor.org/10.1002/hep.21189-
dc.identifier.urihttps://hdl.handle.net/10371/47063-
dc.description.abstractAlthough adefovir dipivoxil (ADV) has a unique profile of delayed and infrequent resistance in treatment-naive chronic hepatitis B patients, the association of ADV resistance with previous lamivudine (LAM) resistance is not well understood. We compared the emergence of the ADV-resistant mutations rtA181V/T and rtN236T between LAM-resistant patients and treatment-naive patients at 48 weeks of ADV monotherapy. Fifty-seven LAM-resistant patients and 38 treatment-naive patients were treated with 10 mg/d ADV for more than 48 weeks. Both baseline and 48-week blood samples were analyzed for ADV-resistant mutations via restriction fragment mass polymorphism analysis. Antiviral responses were evaluated according to changes in serum HBV DNA (measured via real-time polymerase chain reaction) and alanine aminotransferase (ALT) levels and loss of hepatitis B e antigen (HBeAg). After 48 weeks, 10 (18%) of the 57 LAM-resistant patients were found to have developed ADV-resistant mutations, whereas none of the 38 treatment-naive patients developed such mutations (P < .01). Among LAM-resistant patients, the reduction in serum HBV DNA levels was significantly lower in patients with ADV-resistant mutations than in those without such mutations (-1.04 vs. -2.63 log10 copies/mL) (P = .01). However, the rates of serum ALT normalization (60% vs. 55%) and HBeAg loss (14% vs. 21%) were not significantly different between the 2 groups (P > .05). In conclusion, the emergence of the rtA181V/T and rtN236T mutations was more common in LAM-resistant patients than in treatment-naive patients after 48 weeks of ADV therapy and was associated with reduced antiviral efficacy to drug treatment.en
dc.language.isoen-
dc.publisherWiley-Blackwellen
dc.subjectAdenine/administration & dosage/*analogs & derivativesen
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAntiviral Agents/*administration & dosageen
dc.subjectBase Sequenceen
dc.subjectCase-Control Studiesen
dc.subjectDNA, Viral/analysisen
dc.subjectDose-Response Relationship, Drugen
dc.subjectDrug Administration Scheduleen
dc.subjectDrug Resistance, Multiple/*geneticsen
dc.subjectFemaleen
dc.subjectHepatitis B, Chronic/*drug therapy/geneticsen
dc.subjectHumansen
dc.subjectLamivudine/*administration & dosageen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMolecular Sequence Dataen
dc.subjectMutationen
dc.subjectPharmacogeneticsen
dc.subjectPhosphonic Acids/*administration & dosageen
dc.subjectProbabilityen
dc.subjectReverse Transcriptase Polymerase Chain Reactionen
dc.subjectRisk Assessmenten
dc.subjectSeverity of Illness Indexen
dc.subjectStatistics, Nonparametricen
dc.subjectTreatment Outcomeen
dc.subjectViral Loaden
dc.titleIncreased risk of adefovir resistance in patients with lamivudine-resistant chronic hepatitis B after 48 weeks of adefovir dipivoxil monotherapyen
dc.typeArticleen
dc.contributor.AlternativeAuthor이윤선-
dc.contributor.AlternativeAuthor서동진-
dc.contributor.AlternativeAuthor임영석-
dc.contributor.AlternativeAuthor정석원-
dc.contributor.AlternativeAuthor김강모-
dc.contributor.AlternativeAuthor이한주-
dc.contributor.AlternativeAuthor정영화-
dc.contributor.AlternativeAuthor이영상-
dc.contributor.AlternativeAuthor유왕돈-
dc.contributor.AlternativeAuthor김수옥-
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College of Medicine/School of Medicine (의과대학/대학원)Molecular and Genomic Medicine (분자유전체의학전공)Journal Papers (저널논문_분자유전체의학전공)
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