Management of clevudine-resistant chronic hepatitis B: A multicenter cohort study

Eun Young Cho; Hyung Joon Yim; Young Kul Jung; Sang Jun Suh; Yeon Seok Seo; Ji Hoon Kim; Hong Soo Kim; Sae Hwan Lee; Sang Hoon Ahn; Jeong Il Lee; Sook Hyang Jeong; Jin Wook Kim; Jin Woo Lee; In Hee Kim; Hyoung Su Kim; Sang Jong Park; Jeong Mi Lee; Seong Gyu Hwang

doi:10.5009/gnl15597

Management of clevudine-resistant chronic hepatitis B: A multicenter cohort study

Eun Young Cho, Hyung Joon Yim, Young Kul Jung, Sang Jun Suh, Yeon Seok Seo, Ji Hoon Kim, Hong Soo Kim, Sae Hwan Lee, Sang Hoon Ahn, Jeong Il Lee, Sook Hyang Jeong, Jin Wook Kim, Jin Woo Lee, In Hee Kim, Hyoung Su Kim, Sang Jong Park, Jeong Mi Lee, Seong Gyu Hwang

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Background/Aims: Data are lacking regarding the management of chronic hepatitis B (CHB) with resistance to clevudine (CLV). This study evaluated the efficacy of different rescue therapies for CLV-resistant CHB. Methods: Patients with CLV-resistant CHB were enrolled in the cohort, and all patients developed virologic breakthrough during CLV therapy and had confirmed-genotypic resistance to CLV (rtM204I mutation) before enrollment. Results: Of the 107 patients, 12 received adefovir (ADV), 21 received a CLV plus ADV combination (CLV+ADV), 34 received a lamivudine plus ADV combination (LAM+ADV), and 40 received entecavir (ETV) therapy for 48 weeks. The CLV+ADV group had the lowest hepatitis B virus (HBV) DNA level (p<0.0001) and showed the greatest reduction of HBV DNA levels from baseline compared to all other groups (p=0.004) at week 48. HBV DNA was undetectable (<70 IU/mL) in 0%, 57.1%, 21.2%, and 27.5% (p=0.003) of the patients in each group, respectively, at week 48. At the end of the study, the mean alanine transaminase (ALT) level, rate of ALT normalization, and rate of hepatitis B envelope antigen loss or seroconversion did not differ between groups. Conclusions: CLV+ADV combination therapy in patients with CLV-resistant CHB more effectively suppresses HBV replication than ETV, ADV, or LAM+ADV therapy.

Original language	English
Pages (from-to)	129-135
Number of pages	7
Journal	Gut and liver
Volume	11
Issue number	1
DOIs	https://doi.org/10.5009/gnl15597
Publication status	Published - 2017 Jan
Externally published	Yes

Keywords

Clevudine
Hepatitis B, chronic
Resistance
Therapy

ASJC Scopus subject areas

Hepatology
Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.5009/gnl15597

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Cho, E. Y., Yim, H. J., Jung, Y. K., Suh, S. J., Seo, Y. S., Kim, J. H., Kim, H. S., Lee, S. H., Ahn, S. H., Lee, J. I., Jeong, S. H., Kim, J. W., Lee, J. W., Kim, I. H., Kim, H. S., Park, S. J., Lee, J. M., & Hwang, S. G. (2017). Management of clevudine-resistant chronic hepatitis B: A multicenter cohort study. Gut and liver, 11(1), 129-135. https://doi.org/10.5009/gnl15597

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title = "Management of clevudine-resistant chronic hepatitis B: A multicenter cohort study",

abstract = "Background/Aims: Data are lacking regarding the management of chronic hepatitis B (CHB) with resistance to clevudine (CLV). This study evaluated the efficacy of different rescue therapies for CLV-resistant CHB. Methods: Patients with CLV-resistant CHB were enrolled in the cohort, and all patients developed virologic breakthrough during CLV therapy and had confirmed-genotypic resistance to CLV (rtM204I mutation) before enrollment. Results: Of the 107 patients, 12 received adefovir (ADV), 21 received a CLV plus ADV combination (CLV+ADV), 34 received a lamivudine plus ADV combination (LAM+ADV), and 40 received entecavir (ETV) therapy for 48 weeks. The CLV+ADV group had the lowest hepatitis B virus (HBV) DNA level (p<0.0001) and showed the greatest reduction of HBV DNA levels from baseline compared to all other groups (p=0.004) at week 48. HBV DNA was undetectable (<70 IU/mL) in 0%, 57.1%, 21.2%, and 27.5% (p=0.003) of the patients in each group, respectively, at week 48. At the end of the study, the mean alanine transaminase (ALT) level, rate of ALT normalization, and rate of hepatitis B envelope antigen loss or seroconversion did not differ between groups. Conclusions: CLV+ADV combination therapy in patients with CLV-resistant CHB more effectively suppresses HBV replication than ETV, ADV, or LAM+ADV therapy.",

keywords = "Clevudine, Hepatitis B, chronic, Resistance, Therapy",

author = "Cho, {Eun Young} and Yim, {Hyung Joon} and Jung, {Young Kul} and Suh, {Sang Jun} and Seo, {Yeon Seok} and Kim, {Ji Hoon} and Kim, {Hong Soo} and Lee, {Sae Hwan} and Ahn, {Sang Hoon} and Lee, {Jeong Il} and Jeong, {Sook Hyang} and Kim, {Jin Wook} and Lee, {Jin Woo} and Kim, {In Hee} and Kim, {Hyoung Su} and Park, {Sang Jong} and Lee, {Jeong Mi} and Hwang, {Seong Gyu}",

year = "2017",

month = jan,

doi = "10.5009/gnl15597",

language = "English",

volume = "11",

pages = "129--135",

journal = "Gut and liver",

issn = "1976-2283",

publisher = "Joe Bok Chung",

number = "1",

}

TY - JOUR

T1 - Management of clevudine-resistant chronic hepatitis B

T2 - A multicenter cohort study

AU - Cho, Eun Young

AU - Yim, Hyung Joon

AU - Jung, Young Kul

AU - Suh, Sang Jun

AU - Seo, Yeon Seok

AU - Kim, Ji Hoon

AU - Kim, Hong Soo

AU - Lee, Sae Hwan

AU - Ahn, Sang Hoon

AU - Lee, Jeong Il

AU - Jeong, Sook Hyang

AU - Kim, Jin Wook

AU - Lee, Jin Woo

AU - Kim, In Hee

AU - Kim, Hyoung Su

AU - Park, Sang Jong

AU - Lee, Jeong Mi

AU - Hwang, Seong Gyu

PY - 2017/1

Y1 - 2017/1

N2 - Background/Aims: Data are lacking regarding the management of chronic hepatitis B (CHB) with resistance to clevudine (CLV). This study evaluated the efficacy of different rescue therapies for CLV-resistant CHB. Methods: Patients with CLV-resistant CHB were enrolled in the cohort, and all patients developed virologic breakthrough during CLV therapy and had confirmed-genotypic resistance to CLV (rtM204I mutation) before enrollment. Results: Of the 107 patients, 12 received adefovir (ADV), 21 received a CLV plus ADV combination (CLV+ADV), 34 received a lamivudine plus ADV combination (LAM+ADV), and 40 received entecavir (ETV) therapy for 48 weeks. The CLV+ADV group had the lowest hepatitis B virus (HBV) DNA level (p<0.0001) and showed the greatest reduction of HBV DNA levels from baseline compared to all other groups (p=0.004) at week 48. HBV DNA was undetectable (<70 IU/mL) in 0%, 57.1%, 21.2%, and 27.5% (p=0.003) of the patients in each group, respectively, at week 48. At the end of the study, the mean alanine transaminase (ALT) level, rate of ALT normalization, and rate of hepatitis B envelope antigen loss or seroconversion did not differ between groups. Conclusions: CLV+ADV combination therapy in patients with CLV-resistant CHB more effectively suppresses HBV replication than ETV, ADV, or LAM+ADV therapy.

AB - Background/Aims: Data are lacking regarding the management of chronic hepatitis B (CHB) with resistance to clevudine (CLV). This study evaluated the efficacy of different rescue therapies for CLV-resistant CHB. Methods: Patients with CLV-resistant CHB were enrolled in the cohort, and all patients developed virologic breakthrough during CLV therapy and had confirmed-genotypic resistance to CLV (rtM204I mutation) before enrollment. Results: Of the 107 patients, 12 received adefovir (ADV), 21 received a CLV plus ADV combination (CLV+ADV), 34 received a lamivudine plus ADV combination (LAM+ADV), and 40 received entecavir (ETV) therapy for 48 weeks. The CLV+ADV group had the lowest hepatitis B virus (HBV) DNA level (p<0.0001) and showed the greatest reduction of HBV DNA levels from baseline compared to all other groups (p=0.004) at week 48. HBV DNA was undetectable (<70 IU/mL) in 0%, 57.1%, 21.2%, and 27.5% (p=0.003) of the patients in each group, respectively, at week 48. At the end of the study, the mean alanine transaminase (ALT) level, rate of ALT normalization, and rate of hepatitis B envelope antigen loss or seroconversion did not differ between groups. Conclusions: CLV+ADV combination therapy in patients with CLV-resistant CHB more effectively suppresses HBV replication than ETV, ADV, or LAM+ADV therapy.

KW - Clevudine

KW - Hepatitis B, chronic

KW - Resistance

KW - Therapy

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U2 - 10.5009/gnl15597

DO - 10.5009/gnl15597

M3 - Article

C2 - 27538443

AN - SCOPUS:85012875930

SN - 1976-2283

VL - 11

SP - 129

EP - 135

JO - Gut and liver

JF - Gut and liver

IS - 1

ER -

Management of clevudine-resistant chronic hepatitis B: A multicenter cohort study

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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