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Tenofovir (TDF) has stronger antiviral effect than adefovir (ADV) against lamivudine (LAM)-resistant hepatitis B virus (HBV)

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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.

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Abbreviations

ADV:

Adefovir dipovoxil

ALT:

Alanine aminotransferase

CHB:

Chronic hepatitis B

DNA:

Deoxyribonucleic acid

HBeAg:

Hepatitis B e-antigen

HBsAg:

Hepatitis B surface antigen

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

HDV:

Hepatitis D virus

INR:

International normalized ratio

IU:

International units

LLOD:

Lower limit of detection

log:

log10 copies/ml

PCR:

Polymerase chain reaction

PT:

Prothrombin time

TDF:

Tenofovir disoproxil fumarate

VBT:

Virologic breakthrough

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Author notes

  1. Hee Bok Chae

    Present address: Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, South Korea

Authors and Affiliations

  1. Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, 19107-5587, USA

    Hie-Won Hann & Hee Bok Chae

  2. Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107-5587, USA

    Hee Bok Chae

  3. Cancer Genomics Facility, Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, PA, 19107-5587, USA

    Stephen R. Dunn

Authors
  1. Hie-Won Hann
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  2. Hee Bok Chae
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  3. Stephen R. Dunn
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Corresponding author

Correspondence to Hie-Won Hann.

Additional information

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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Hann, HW., Chae, H.B. & Dunn, S.R. Tenofovir (TDF) has stronger antiviral effect than adefovir (ADV) against lamivudine (LAM)-resistant hepatitis B virus (HBV). Hepatol Int 2, 244–249 (2008). https://doi.org/10.1007/s12072-008-9045-6

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  • DOI: https://doi.org/10.1007/s12072-008-9045-6

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