Adefovir dipivoxil for the treatment of HBeAg-positive chronic hepatitis B: a review of the major clinical studies

Abstract

Adefovir dipivoxil (ADF) is an orally bioavailable prodrug of adefovir, a phosphonate nucleotide analog of adenosine monophosphate [1]. Adefovir has potent in vitro activity against hepadnaviruses, retroviruses and herpesviruses [2–5]. The intracellular compound, adefovir diphosphate, acts as a competitive inhibitor and chain-terminator of hepatitis B virus (HBV) replication mediated by HBV DNA polymerase [6]. Ten mg daily of adefovir has recently been licensed for the treatment of chronic hepatitis B in adults with evidence of HBV replication. The efficacy of ADF was investigated in patients with compensated liver disease and evidence of HBV replication; in patients failing lamivudine therapy, including posttransplantation patients, patients with compensated and decompensated liver failure and patients co-infected with human immunodeficiency virus (HIV). Several of these studies have been published. The data in HBeAg-positive patients is reviewed in this manuscript.