High rate of adefovir-lamivudine combination therapy in nucleoside-naïve patients with chronic hepatitis B in France: results of a national survey in 1730 patients.

Abstract

BACKGROUND/AIMS:

This study describes the types of therapy used in chronic hepatitis B (CHB) in France and patient characteristics according to therapy.

METHODS:

This was a descriptive, multicenter, retrospective study in 1730 patients (54 centers). We collected information about demographics, epidemiology, severity of hepatitis B virus-related liver disease, antiviral therapy, response (hepatitis B viral DNA and alanine aminotransferase normalization changes), dose modification, or treatment interruption.

RESULTS:

Approximately, 60% of patients enrolled had never been treated for CHB and 33.1% were currently receiving treatment (47% first line). Of those receiving treatment, 30% were receiving adefovir-lamivudine combination. Of those receiving first-line therapy, 40, 30, and 15% were receiving lamivudine, adefovir, or adefovir-lamivudine combination, respectively. Complete and partial virological responses were seen in 59 and 13% of patients, respectively. In patients having been treated at least once, biochemical response was seen in 45%. Lamivudine or adefovir-resistant mutants were detected in 32.6 and 22.1% of patients treated by these antiviral agents, respectively.

CONCLUSION:

In France, among patients with CHB, we observed that one-third were receiving therapy, and, of these, 30% were receiving first-line (15%) or second-line (15%) adefovir-lamivudine combination therapy. This observation highlights that clinical practice is influenced by available scientific data on resistance induced by monotherapy.

• Authors: Patrick Marcellin, Jean-François Cadranel, Thierry Fontanges, Thierry Poynard, Stanislas Pol, Christian Trepo, Patrick Blin, Bruno Bregman, Nathalie Schmidely, Françoise Roudot-Thoraval, Jean-Pierre Zarski
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 22 Issue 11 Pg. 1290-6 (Nov 2010) ISSN: 1473-5687 [Electronic] England
• PMID: 20964259 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Biomarkers
• DNA, Viral
• Hepatitis B e Antigens
• Organophosphonates
• Lamivudine
• adefovir
• Alanine Transaminase
• Adenine

Topics

• Adenine (analogs & derivatives, therapeutic use)
• Adult
• Alanine Transaminase (blood)
• Antiviral Agents (therapeutic use)
• Biomarkers (blood)
• Cross-Sectional Studies
• DNA, Viral (blood)
• Drug Resistance, Multiple, Viral
• Drug Therapy, Combination
• Drug Utilization
• Female
• France (epidemiology)
• Health Care Surveys
• Hepatitis B e Antigens (blood)
• Hepatitis B virus (genetics, immunology)
• Hepatitis B, Chronic (diagnosis, drug therapy, epidemiology)
• Humans
• Lamivudine (therapeutic use)
• Male
• Middle Aged
• Organophosphonates (therapeutic use)
• Practice Patterns, Physicians' (statistics & numerical data)
• Registries
• Retrospective Studies
• Treatment Outcome
• Viral Load
• Young Adult