Variables determining the virologic response to adefovir treatment in patients with chronic HBV infection previously treated with lamivudine

摘要

The objective of this study was the investigation of the variables that determine the development of virological response to adefovir treatment. In this retrospective case-control study, files of patients with chronic HBV infection which previously used adefovir throughout? different periods were examined for gender, age, height, weight, Knodell and fibrosis scores in liver biopsies, serum? ALT and HBV DNA levels, HBeAg status and alcohol use. Independent variables determining the virologic response to adefovir treatment were investigated. This study included 63 patients. Forty-one (65.1%) of the patients were male, and their median ages were 42 (range 19 to 65). Twenty-five (39.7%) of the study population were HBeAg positive. The cumulative virological response rates on the 6th, 12th, 18th, 24th, 30th?and 36th?months of adefovir therapy were found to be 31.7, 38.4, 38.4, 44, 44 and 58%, respectively. HBeAg negativity and the ratio of decrease in serum HBV DNA levels at 6th?month of the treatment were the independent variables determining the response to the adefovir treatment [Odds ratio (95% confidence intervals) were 4.498 (1.194-16.939) for HBeAg negativity (p=0,026) and 1.598 (1.232-2.072) for the ratio of decrease in serum HBV DNA levels at 6th?month of the treatment (p=0.0001). It was suggested that adefovir was more effective in HBeAg negative patients, and was more rational to continue the treatment in patients who had a decrease of at least 2log10units in serum HBV DNA levels at 6th?month of treatment.