Tenofovir (TDF) has stronger antiviral effect than adefovir (ADV) against lamivudine (LAM)-resistant hepatitis B virus (HBV) |
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Authors: | Hie-Won Hann Hee Bok Chae Stephen R Dunn |
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Institution: | (1) Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5587, USA;(2) Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5587, USA;(3) Present address: Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, South Korea;(4) Cancer Genomics Facility, Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5587, USA |
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Abstract: | Objectives We retrospectively compared the antiviral effect of tenofovir disoproxil fumarate (TDF) with that of adefovir dipivoxil (ADV)
for patients with chronic hepatitis B (CHB) who developed resistance to lamivudine (LAM).
Materials and methods One hundred nine patients (86 males), all Asian-American except 1 Caucasian male, with LAM resistance received TDF or ADV.
HBV DNA levels were measured every 3 months. The HBeAg loss and ALT normalization were assessed at 12 months on therapy.
Results Forty-four patients (37 males) received TDF (12 with LAM) and 65 (49 males) received ADV (18 with LAM). Median ages (years)
for TDF and ADV were 49 (32–68) and 45 (22–68), respectively. Median duration of therapy was 13 months (6–38) and 17 months
(6–34) for the TDF and ADV groups. Baseline HBV DNA levels (log10 copies/ml) were 6.2 ± 1.7 for the TDF and 6.5 ± 1.6 for ADV groups. Baseline ALT (IU/l) levels were 77.0 ± 86.0 and 100 ± 195
for the TDF and ADV (P = 0.46) groups, respectively. At 12 months, mean
levels of log10 HBV DNA were 1.5 ± 1.0 and 4.3 ± 2.2 for TDF and ADV (P = 0.01). HBeAg loss and ALT normalization at 12 months showed no differences. Using a single factor, ANOVA (2-tailed P value), 4 groups, TDF (n = 32), TDF + LAM (12), ADV (47), and ADV + LAM (18), were compared. HBV DNA reduction at 12 months was the greatest for TDF + LAM
(P < 0.001).
Conclusions Our results suggest that for LAM-resistant HBV, TDF, alone or combined with LAM exerts greater viral reduction than ADV. However,
no difference in HBeAg loss was observed. It appears that stronger HBV DNA reduction may not necessarily accelerate HBeAg
loss.
The author (H.W.H.) who has taken part in this study has declared a relationship with the manufacturers of the drugs involved
either in the past or present. |
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Keywords: | HBV Adefovir Tenofovir Lamivudine Viral resistance |
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