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Sustained virological and biochemical responses to lamivudine and adefovir dipivoxil combination in a chronic hepatitis B infection despite mutations conferring resistance to both drugs.

Abstract : ABSTRACT: BACKGROUND: Sequential monotherapies of nucleotide analogs used in chronic hepatitis B treatment can lead to the selection of a resistance mutation to each antiviral drug. CASE PRESENTATION: A patient with chronic hepatitis B was successively treated with lamivudine monotherapy, lamivudine-adefovir dual therapy, adefovir monotherapy and again with an adefovir-lamivudine dual therapy. Lamivudine-associated mutations (rtL180M and rtM204V/I) followed by adefovir-associated mutations (rtN236T and rtA181V) emerged during the two monotherapy regimens. Despite the presence of rtM204V/I, rtA181V, and rtN236T mutations at the beginning of the second dual therapy, sustained biochemical and virological responses have been observed thus far after 23 months. CONCLUSION: This case illustrates that rtM204V/I, rtA181V, and rtN236T resistance mutations can coexist in a patient but do not preclude the recycling of lamivudine and adefovir in combination therapy, when no other therapeutic choices are available.
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https://www.hal.inserm.fr/inserm-00324951
Contributor : Alain Duperray <>
Submitted on : Thursday, September 25, 2008 - 5:06:50 PM
Last modification on : Thursday, August 27, 2020 - 11:36:03 AM

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Sylvie Larrat, Marie-Noëlle Hilleret, Raphaele Germi, Julien Lupo, Sandrine Nicod, et al.. Sustained virological and biochemical responses to lamivudine and adefovir dipivoxil combination in a chronic hepatitis B infection despite mutations conferring resistance to both drugs.. Comparative Hepatology, BioMed Central, 2008, 7, pp.3. ⟨10.1186/1476-5926-7-3⟩. ⟨inserm-00324951⟩

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