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

  • Hie-Won HannEmail author
  • Hee Bok Chae
  • Stephen R. Dunn
Original Article

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.

Keywords

HBV Adefovir Tenofovir Lamivudine Viral resistance 

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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Copyright information

© Asian Pacific Association for the Study of the Liver 2008

Authors and Affiliations

  • Hie-Won Hann
    • 1
    Email author
  • Hee Bok Chae
    • 1
    • 2
    • 3
  • Stephen R. Dunn
    • 4
  1. 1.Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of MedicineThomas Jefferson University HospitalPhiladelphiaUSA
  2. 2.Department of Pathology, Anatomy, and Cell BiologyThomas Jefferson University HospitalPhiladelphiaUSA
  3. 3.Department of Internal MedicineChungbuk National University HospitalCheongjuSouth Korea
  4. 4.Cancer Genomics Facility, Kimmel Cancer CenterThomas Jefferson University HospitalPhiladelphiaUSA

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