약제 내성 만성 B형간염 환자에서 테노포비어를 포함한 구원치료의 효과
- Alternative Title
- Efficacy of tenofovir-based rescue therapy for patients with drug-resistant chronic hepatitis B
- Abstract
- BACKGROUND/AIMS: Tenofovir disoproxil fumarate (TDF) plays a pivotal role in the management of drug-resistant chronic hepatitis B. However, it remains unclear whether TDF-nucleoside analogue combination therapy provides better outcomes than TDF monotherapy. This study aimed to compare the efficacy of TDF monotherapy with that of TDF-nucleoside analogue combination therapy in patients with drug-resistant chronic hepatitis B. METHODS: This retrospective cohort study included 76 patients receiving TDF-based rescue therapy for more than 12 months. Suboptimal response was defined as serum HBV-DNA level of > 60 IU/mL during prior rescue therapy. Multi-drug resistance was defined as the presence of two or more drug resistance-related mutations confirmed by mutation detection assay. The relationship between baseline characteristics and virologic response (HBV DNA < 20 IU/mL) at 12 months were evaluated using logistic regression analysis. RESULTS: Fifty-five patients (72.4%) were suboptimal responders to prior rescue therapy, and 26 (34.2%) had multi-drug resistance. Forty-two patients (55.3%) received combination therapy with nucleoside analogues. Virologic response at 12 months was not significantly different between the TDF monotherapy group and TDF-nucleoside analogue combination therapy group (p = 0.098). The serum HBV DNA level was reduced to -4.49 ± 1.67 log10 IU/mL in the TDF monotherapy group and to -3.97 ± 1.69 log10 IU/mL in the TDF-nucleoside analogue combination therapy group at 12 months (p = 0.18). In multivariate analysis, female sex (p = 0.032), low baseline HBV-DNA level (p = 0.013), and TDF monotherapy (p = 0.046) were predictive factors for virologic response at 12 months. CONCLUSIONS: TDF monotherapy showed similar efficacy to that of TDF-nucleoside analogue combination therapy in patients with drug-resistant chronic hepatitis B.
- All Author(s)
- K. Choi
; H. M. Lee
; B. G. Jun
; S. H. Lee
; H. S. Kim
; S. G. Kim
; Y. S. Kim
; B. S. Kim
; S. W. Jeong
; J. Y. Jang
; Y. D. Kim
; G. J. Cheon
- Issued Date
- 2015
- Type
- Article
- Keyword
- Hepatitis B; Drug resistance; Tenofovir; Virologic response
- Publisher
- 대한소화기학회
The Korean Society of Gastroenterology
- ISSN
- 1598-9992
; 2233-6869
- Citation Title
- 대한소화기학회지
The Korean Journal of Gastroenterology
- Citation Volume
- 65
- Citation Number
- 1
- Citation Start Page
- 35
- Citation End Page
- 42
- Language(ISO)
- kor
- DOI
- 10.4166/kjg.2015.65.1.35
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/3170
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