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AIM:To evaluate virological response to adefovir(ADV) monotherapy and emergence of ADV-resistant mutations in lamivudine(LAM)-resistant chronic hepatitis B patients.METHODS:Seventy-seven patients with documented LAM resistance who were treated with 10 mg/d ADV for>96 wk were analyzed for ADV resistance.RESULTS:At week 48 and 96,eight(10%)and 14(18%)of 77 LAM-resistant patients developed the ADV-resistant strain(rtA181V/T and/or rtN236T mutations),respectively.Hepatitis B virus(HBV)DNA levels during therapy were significantly higher in patients who developed ADV resistance than in those who did not.Incidence of ADV resistance at week 96 was 11%,8%and 6%among patients with complete virological response(HBV DNA level<60 IU/mL);0%,5%and 19%among patients with partial virological response(HBV DNA level≥60 to 2000 IU/mL);and 32%,34% and 33%among patients with inadequate virological response(HBV DNA levels>2000 IU/mL)at week 12,week 24 and week 48,respectively.HBV DNA levels >2000 IU/mL at week 24 showed best performance characteristics in predicting ADV resistance.CONCLUSION:Development of ADV resistance mutations was associated with HBV DNA levels,which could identify patients with LAM resistance who are likely to respond to ADV monotherapy.
AIM: To evaluate virological response to adefovir (ADV) monotherapy and emergence of ADV-resistant mutations in lamivudine (LAM) -resistant chronic hepatitis B patients. METHODS: Seventy-seven patients with documented LAM resistance who were treated with 10 mg / d ADV resistant patients developed the ADV-resistant strain (rtA181V / T and / or rtN236T mutations) for> 96 wk were analyzed for ADV resistance .RESULTS: At week 48 and 96, eight (10%) and 14 (18%) of 77 LAM- ), respectively. Hepatitis B virus (HBV) DNA levels during therapy were significantly higher in patients who developed ADV resistance than in those who did not .idence of ADV resistance at week 96 was 11%, 8% and 6% among patients with complete 0%, 5% and 19% among patients with partial virological response (HBV DNA level ≧ 60 to 2000 IU / mL); and 32%, 34% and 33% among patients with inadequate virological response (HBV DNA levels> 2000 IU / mL) at week 12, week 24 and week 48, respectively. HBV DNA levels> 2000 IU / mL at week 24 showed best performance characteristics in predicting ADV resistance. CONCLUSION: Development of ADV resistance mutations was associated with HBV DNA levels, which could identify patients with LAM resistance who are likely to respond to ADV monotherapy.