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

Eur J Gastroenterol Hepatol. 2010 Nov;22(11):1290-6. doi: 10.1097/meg.0b013e32832fba4f.

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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenine / analogs & derivatives*
  • Adenine / 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
  • Hepatitis B virus / immunology
  • Hepatitis B, Chronic / diagnosis
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / 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

Substances

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