Skip Navigation LinksHome > December 2012 - Volume 55 - Issue 6 > Virologic Responses to Add-on Adefovir Dipivoxil Treatment V...
Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e318262a737
Original Articles: Hepatology and Nutrition

Virologic Responses to Add-on Adefovir Dipivoxil Treatment Versus Entecavir Monotherapy in Children With Lamivudine-resistant Chronic Hepatitis B

Chu, MiAe*; Cho, Seung Man*; Choe, Byung-Ho*; Cho, Min Hyun*; Kwon, Soonhak*; Lee, Won Kee

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Abstract

Purpose: The aim of the study was to compare the virologic response to adefovir (ADV) add-on therapy with switching to entecavir (ETV) monotherapy in children and adolescents with chronic hepatitis B (CHB) who have developed lamivudine (LAM) resistance during LAM treatment.

Methods: Twenty-seven consecutive patients with CHB who had developed LAM resistance during LAM treatment were included. Of these 27 patients, 8 patients were treated with the addition of ADV to ongoing LAM and 8 patients were treated by switching to ETV monotherapy and each of these 16 patients were compared with the 11 patients who were treated by switching to ADV alone, as a historical control. Therapeutic responses to treatment were evaluated at 12, 24, 36, and 48 weeks from the initiation of therapy by measuring the decrement of hepatitis B virus (HBV)-DNA titers.

Results: The therapeutic period for HBV-DNA titer decrement (>2 log10 IU/mL) was significantly shorter in both the LAM+ADV group and the ETV group than in the ADV group (P= 0.008); however, there was no significant difference between the LAM+ADV group and the ETV group. The rate of virologic response, defined as decrement in HBV-DNA titer to undetectable levels at 24 weeks, was significantly higher in both the LAM+ADV group and the ETV group than in the ADV group (P= 0.029).

Conclusions: Both the LAM+ADV combination therapy and ETV monotherapy exhibited significantly more effective virologic responses compared to the ADV monotherapy in children and adolescents with LAM-resistant CHB, although there was no significant difference between the LAM+ADV group and the ETV group.

Copyright 2012 by ESPGHAN and NASPGHAN

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