Tenofovir (TDF) has stronger antiviral effect than adefovir (ADV) against lamivudine (LAM)-resistant hepatitis B virus (HBV)
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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.
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).
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.
KeywordsHBV Adefovir Tenofovir Lamivudine Viral resistance
Chronic hepatitis B
Hepatitis B e-antigen
Hepatitis B surface antigen
Hepatitis B virus
Hepatitis C virus
Hepatitis D virus
International normalized ratio
Lower limit of detection
Polymerase chain reaction
Tenofovir disoproxil fumarate
- 8.Chae HB, Hann HW. Baseline HBV DNA level is the most important factor associated with viral breakthrough (BT) during lamivudine (LVD) therapy for chronic hepatitis B (CHB). Gastroenterology. 2006;130:A846.Google Scholar
- 14.Locarnini S, Qi X, Arterburn S, Snow A, Brosgart CL, Currie G, et al. Incidence and predictors of emergence of adefovir resistant HBV during four years of emergence of adefovir resistant HBV during four years of adefovir dipivoxil (ADV) therapy for patients with chronic hepatitis B (CHB) [Abstract]. J Hepatol. 2005;42 Suppl 2:A36.Google Scholar