Abstract
We evaluated second-line salvage therapy with adefovir + telbivudine (group 1), adefovir followed by adefovir + telbivudine (group 2), or lamivudine + adefovir followed by adefovir + telbivudine (group 3) in hepatitis B patients with an inadequate virologic response to lamivudine treatment. Simple linear regression analysis showed that for each additional month of treatment, the most significant reduction in viral load occurred in group 1 (HBV DNA [Log10 IU/mL]: group 1, −0.149; group 2, -0.081; group 3, −0.123). Generalized estimating equation analysis revealed that compared to group 1, hepatitis B virus (HBV) DNA levels were 1.203 and 0.443 Log10 IU/mL higher in groups 2 and 3, respectively. Overall, a significant reduction in viral load (−0.060 Log10 IU/mL) was observed for each additional month of treatment. Adefovir + telbivudine treatment resulted in a significant reduction in HBV DNA levels. Moreover, telbivudine treatment resulted in a significant reduction in viral load (−0.050 Log10 IU/mL) compared to lamivudine treatment after the emergence of lamivudine resistance.Electronic supplementary materialThe online version of this article (doi:10.1007/s00705-013-1786-4) contains supplementary material, which is available to authorized users.
Highlights
Chronic hepatitis B virus (HBV) infection is a cause of significant mortality and morbidity worldwide
We evaluated second-line salvage therapy with adefovir ? telbivudine, adefovir followed by adefovir ? telbivudine, or lamivudine ? adefovir followed by adefovir ? telbivudine in hepatitis B patients with an inadequate virologic response to lamivudine treatment
The results showed that ADV ? LdT treatment resulted in a better reduction of 1.593 (Log10 IU/ml) in HBV DNA concentrations than ADV monotherapy (p \ 0.001)
Summary
Chronic hepatitis B virus (HBV) infection is a cause of significant mortality and morbidity worldwide. According to a WHO report published in 2008, two billion people were infected with the virus, and 350 million of these suffered from chronic HBV infection [1]. HBV DNA levels are the principal indicator of the extent of infection. Other indicators of infection include alanine transaminase (ALT) and hepatitis B e antigen (HBeAg); changes in these levels are dependent on the phase and extent of infection. Indications for treatment depend on the presence or absence of HBeAg. Typically, HBeAg-positive patients with HBV DNA levels C 20,000 IU/mL and elevated ALT levels of two times the upper limits of normal are considered for treatment [2, 3]
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