caa a22 4500 445795883 CHVBK 20180317145125.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10620-010-1537-2 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1537-2 The Level of HBV DNA at Month 12 Is an Important Predictor of Virological Breakthrough During Adefovir Monotherapy in Chronic Hepatitis B Patients with Lamivudine Resistance [Elektronische Daten] [Moon-Chan Kim, Seok Jung, Jung Shin, Neung Park] Background and Aims: The aim of this study was to determine the optimal time and HBV DNA levels during the treatment period for prediction of virological breakthrough (VBT) 3years after adefovir monotherapy in chronic hepatitis B (CHB) patients with lamivudine resistance. Methods: We consecutively analyzed HBV DNA levels within 12months in 210 lamivudine-resistant CHB patients treated with adefovir monotherapy for more than 36months. Results: VBT, genotypic adefovir mutations, and virologic responses were observed in 52 (24.8%), 37 (17.6%), and 117 (55.7%) cases within 3years of treatment, respectively. Using receiver-operating characteristic curve analysis, HBV DNA levels at month 12 had a greater power (AUROC, 0.839; 95% CI, 0.759-0.919; p<0.001) to predict VBT after 3years of treatment. The best cut-off value of HBV DNA levels at month 12 for predicting VBT at 3years of treatment was 200IU/ml with a sensitivity and negative predictive value of 88.5 and 94.3%, respectively. Using this time and cut-off value, VBT had developed in six (5.7%) of the patients with HBV DNA levels <200IU/ml (n=105) and 46 (43.8%) of the patients with HBV DNA levels ≥200IU/ml (n=105) at month 12 (p<0.001). Moreover, virological response or HBeAg seroconversion remained higher at 82.9 and 81.2%, respectively. Conclusions: In patients who were switched to adefovir monotherapy as rescue therapy for lamivudine resistance before the introduction of current therapeutic guidelines, measurements of HBV DNA levels at month 12 should be performed to predict VBT. Early termination of adefovir monotherapy should be considered for patients who still have HBV DNA ≥200IU/ml (3 log10 copies/ml) at 12months of treatment. Springer Science+Business Media, LLC, 2011 Hepatitis B virus nationallicence Adefovir dipivoxil nationallicence Lamivudine resistance nationallicence HBV DNA level nationallicence Kim Moon-Chan Department of Family Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea aut Jung Seok Department of Internal Medicine and Biomedical Research Center, University of Ulsan College of Medicine, Ulsan University Hospital, 290-3 Jeonha-dong, Dong-gu, 682-714, Ulsan, South Korea aut Shin Jung Department of Internal Medicine and Biomedical Research Center, University of Ulsan College of Medicine, Ulsan University Hospital, 290-3 Jeonha-dong, Dong-gu, 682-714, Ulsan, South Korea aut Park Neung Department of Internal Medicine and Biomedical Research Center, University of Ulsan College of Medicine, Ulsan University Hospital, 290-3 Jeonha-dong, Dong-gu, 682-714, Ulsan, South Korea aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/4(2011-04-01), 1215-1221 0163-2116 56:4<1215 2011 56 10620 https://doi.org/10.1007/s10620-010-1537-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1537-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kim Moon-Chan Department of Family Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea aut NATIONALLICENCE 700 1- Jung Seok Department of Internal Medicine and Biomedical Research Center, University of Ulsan College of Medicine, Ulsan University Hospital, 290-3 Jeonha-dong, Dong-gu, 682-714, Ulsan, South Korea aut NATIONALLICENCE 700 1- Shin Jung Department of Internal Medicine and Biomedical Research Center, University of Ulsan College of Medicine, Ulsan University Hospital, 290-3 Jeonha-dong, Dong-gu, 682-714, Ulsan, South Korea aut NATIONALLICENCE 700 1- Park Neung Department of Internal Medicine and Biomedical Research Center, University of Ulsan College of Medicine, Ulsan University Hospital, 290-3 Jeonha-dong, Dong-gu, 682-714, Ulsan, South Korea aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/4(2011-04-01), 1215-1221 0163-2116 56:4<1215 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer