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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology 제17권 제4호
발행연도
2011.1
수록면
261 - 267 (7page)

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Background/Aims: We investigated the durability of the biochemical and virologic responses after adefovir (ADV)discontinuation in lamivudine-resistant (LMV-R) chronic hepatitis B (CHB) patients, and the outcomes of ADV discontinuation compared to that of ADV maintenance. Methods: The indication for ADV treatment cessation was an undetectable level of hepatitis B virus (HBV) DNA documented on two occasions at least 6 months apart. All patients received additional ADV for at least 12 months after the confirmation of undetectable HBV DNA (Cobas TaqMan PCR assay, <70 copies/mL). Of 36 patients who had a sufficient ADV therapeutic effect, 19 discontinued ADV treatment, while the others maintained it. A virologic rebound was arbitrarily defined as the redetection of HBV DNA at a level higher than 105 copies/mL. Results: In the ADV discontinuation group, ADV treatment and additional therapy were administered for medians of 33 months (range, 12-47 months) and 18 months, respectively. The patients were followed for a median of 12 months (range,3-30 months) after ADV cessation. During that period, 18 of 19 patients (95%) experienced viral relapse. Viral rebound was observed in six patients (32%). However, 12 of 18 patients (67%) exhibited serum HBV DNA levels of less than 105 copies/mL. Biochemical relapses were observed in four of the six patients with viral rebound. In the ADV maintenance group, patients were treated for a median of 53 months (range, 31-85 months), and 9 patients (53%) experienced viral breakthrough. Conclusions: During short-term follow-up after ADV discontinuation, most patients (95%) exhibited viral relapse, whereas and viral breakthrough occurred in about half of patients (53%) maintained on ADV therapy. Therefore,the durability of virologic response after ADV discontinuation in LMV-R patients was unsatisfactory. In addition, and viral breakthrough was not infrequent in the ADV continuation group.
#Adefovir #Chronic hepatitis B #Durability #Lamivudine

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참고문헌 (22)

참고문헌 신청
Bortolotti F / 2006 / Chronic hepatitis B in children after e antigen seroclearance: final report of a 29-year longitudinal study / Hepatology 43 : 556 ~ 562 google schola Chang TT / 2004 / Durability of HBeAg seroconversion after adefovir dipivoxil treatment for chronic hepatitis B (CHB) / J Hepatol 40 (1) : 126 ~ google schola Chen CJ / 2007 / Long-term outcomes in hepatitis B: the REVEAL-HBV study / Clin Liver Dis 11 : 797 ~ 816 google schola Chu CM / 1985 / Natural history of chronic hepatitis B virus infection in Taiwan: studies google schola European Association For The Study Of The Liver / 2009 / EASL Clinical Practice Guidelines: management of chronic hepatitis B / J Hepatol 50 : 227 ~ 242 google schola

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