Efficacy and Safety of Adefovir Dipivoxil in Patients with Decompensated Liver Cirrhosis with Lamivudine Resistance Compared to Patients with Compensated Liver Disease |
Won Moon, M.D., Moon Seok Choi, M.D., Yu Mi Moon, R.N., Seung Woon Paik, M.D.,
Joon Hyoek Lee, M.D., Kwang Cheol Koh, M.D., Byung Chul Yoo, M.D., Jong Chul Rhee, M.D.
and Sang Goon Shim, M.D.1 |
Department of Medicine, Samsung Medical Center and Masan Samsung Hospital1, Gastrointestinal Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea |
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ABSTRACT |
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Background/Aims Adefovir dipivoxil is effective in patients with lamivudine-resistant hepatitis B virus
(HBV). However, little is known about its role in Korean patients with decompensated liver cirrhosis. We
retrospectively evaluated the efficacy and safety of adefovir dipivoxil in patients with decompensated liver
cirrhosis with lamivudine resistance, and we compared this to the patients having compensated liver disease.
Methods The patients with lamivudine-resistant chronic liver disease were enrolled and they received
adefovir dipivoxil 10 mg daily. The clinical course and the biochemical and virological response of the
decompensated cirrhosis group were compared with those of the patients with compensated liver disease
group. Results: One-hundred and one patients (the decompensated cirrhosis group, n=53; the compensated
liver disease group, n=48) were evaluated. During the following up, 13 patients in the decompensated
group and 4 patients in the compensated group dropped out of the treatment (P=0.011). After adefovir
treatment, the proportion of patients with serum HBV DNA below 0.5 pg/mL in the decompensated group was
less than that in the compensated group (50.9% vs. 83.3%, P=0.001), but the rates of normalized ALT, HBeAg
loss and HBeAg seroconversion did not differ. The change of the Child-Pugh score in the decompensated group
was 9.1±1.8 to 6.9±1.6 (P<0.001). The biochemical response in decompensated group was slower than that in
the compensated group. Renal toxicity was not observed in either group. Conclusions: These results suggest
that adefovir dipivoxil would be an effective and safe treatment for patients with decompensated liver cirrhosis
with lamivudine resistance, but its effect might be limited and slower for decompensated cirrhosis. (Korean J
Hepatol 2005;11:125-134) |
KeyWords:
Adefovir dipivoxil, Liver cirrhosis, Lamivudine |
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