The efficacy of 3 years adefovir monotherapy in chronic hepatitis B patients with lamivudine resistance

Objective To evaluate the effect of rescue monotherapy of adefovir (ADV) in patients with chronic hepatitis B (CHB) who had developed drug resistance to lamivudine (LAM) and moreover to gain experience of the treatment of LAM resistant.Methods A total of 60 treated CHB patients with LAM resistance were enrolled in the present study.The patients′ baseline characteristics such as age, gender, blood tests and hepatitis B virus (HBV) DNA were collected;therapy duration and the response of each patient were also recorded.Results 20 of 60 cases had HBV DNA quantitative rebound ≥ 1log10copies/ml HBV DNA sequencing rtM204I/V, rtL180M sites of variation were seen in the remaining 40 cases.Biochemical breakthrough was observed in LAM-resistant patients being treated with ADV monotherapy.Completion of 156 weeks of treatment in 42 cases.In low copy HBV DNA group (baseline HBV DNA 103-105 copies /ml) after 12-156 weeks of treatment, HBV DNA negative rates were 80.6%.Whereas in high copy HBV DNA group (baseline HBV DNA≥106 copies /ml) , negative rates were 40.7%-44.7%.The two groups had significant differences (P<0.01) .HBV DNA negative rate gradually increased with prolonged treatment.When the treatment was at 156 week, HBeAg seroconversion rate was 24.1%.Four cases of variant sites detected rtA181V/I/S using ETV.Conclution ADV monotherapy in the treatment of LAM-resistant chronic hepatitis B have certain effect, and is more suitable for patients with low viral load.