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dc.contributor.author김태엽-
dc.date.accessioned2017-08-03T00:06:08Z-
dc.date.available2017-08-03T00:06:08Z-
dc.date.issued2015-10-
dc.identifier.citationWORLD JOURNAL OF GASTROENTEROLOGY, v. 21, NO 38, Page. 10874-10882en_US
dc.identifier.issn1007-9327-
dc.identifier.issn2219-2840-
dc.identifier.urihttps://www.wjgnet.com/1007-9327/full/v21/i38/10874.htm-
dc.identifier.urihttp://hdl.handle.net/20.500.11754/28219-
dc.description.abstractAIM: To evaluate the long-term efficacy adefovir (ADV)-based combination therapies in entecavir (ETV)-resistant chronic hepatitis B (CHB) patients. METHODS: Fifty CHB patients with genotypic resistance to ETV at 13 medical centers in South Korea were included for the analysis. All the patients received rescue therapy with the combination of ADV plus ETV (ADV/ETV, n = 23) or ADV plus lamivudine (LMV) (ADV/LMV, n = 27) for more than 12 mo. Patients were monitored at least every 3-4 mo during ADV-based combination therapy by clinical examination as well as biochemical and virological assessments. Hepatitis B virus (HBV) DNA levels were measured by real-time PCR and logarithmically transformed for analysis. Cumulative rates of virologic response (VR; HBV DNA < 20 IU/mL) were calculated using the Kaplan-Meier method, and the difference was determined by a log-rank test. Multivariate logistic regression and Cox proportional hazards models were used to identify independent risk factors significantly associated with short-term and long-term VR, respectively. RESULTS: Baseline median HBV DNA levels were 5.53 (2.81-7.63) log10 IU/mL. The most commonly observed ETV genotypic mutation sites were rt184 and rt202. Patients were treated for a median of 27 (12-45) mo. Overall, cumulative VR rates at 6, 12, 24, and 36 mo were 26%, 36%, 45%, and 68%, respectively. Patients treated with the ADV/ETV combination showed higher cumulative VR rates (35%, 43%, 65%, and 76%, respectively) than those with the ADV/LAM combination (18%, 30%, 30%, and 62%, respectively; P = 0.048). In the multivariate analysis, low baseline HBV DNA levels (< 5.2 log10 IU/mL) and initial virologic response at 3 mo (IVR-3; HBV DNA < 3.3 log10 IU/mL after 3 mo) were independent predictive factors for VR. Patients with favorable predictors achieved cumulative VR rates up to 90% at 36 mo. During the same period, the cumulative incidence of virologic breakthrough was as low as 6% in patients with the both favorable predictors. CONCLUSION: If tenofovir is not available, ADV/ETV combination could be considered in ETV-resistant patients with low HBV DNA titers, and may be continued if IVR-3 is achieved.en_US
dc.description.sponsorshipSupported by Research Funds from the Korean Association for the Study of the Liver (in part).en_US
dc.language.isoenen_US
dc.publisherBAISHIDENG PUBLISHING GROUP INCen_US
dc.subjectAdefoviren_US
dc.subjectChronic hepatitis Ben_US
dc.subjectEntecaviren_US
dc.subjectLamivudineen_US
dc.subjectResistanceen_US
dc.titleManagement of entecavir-resistant chronic hepatitis B with adefovir-based combination therapiesen_US
dc.typeArticleen_US
dc.relation.no38-
dc.relation.volume21-
dc.identifier.doi10.3748/wjg.v21.i38.10874-
dc.relation.page10874-10882-
dc.relation.journalWORLD JOURNAL OF GASTROENTEROLOGY-
dc.contributor.googleauthorKim, Hyoung Su-
dc.contributor.googleauthorYim, Hyung Joon-
dc.contributor.googleauthorJang, Myoung Kuk-
dc.contributor.googleauthorPark, Ji Won-
dc.contributor.googleauthorSuh, Sang Jun-
dc.contributor.googleauthorSeo, Yeon Seok-
dc.contributor.googleauthorKim, Ji Hoon-
dc.contributor.googleauthorKim, Bo Hyun-
dc.contributor.googleauthorPark, Sang Jong-
dc.contributor.googleauthorKim, Tae Yeob-
dc.relation.code2015008914-
dc.sector.campusS-
dc.sector.daehakRESEARCH INSTITUTE[S]-
dc.sector.departmentINSTITUTE OF MEDICAL SCIENCE-
dc.identifier.pidktydoc-


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