Rapid HBV DNA decrease (week 12) is an important prognostic factor for first-line treatment with adefovir dipivoxil...

Area of Science:

• Hepatology
• Virology
• Pharmacology

Background:

• Chronic hepatitis B (CHB) management requires understanding factors influencing treatment response.
• First-line therapy with adefovir dipivoxil (ADV) efficacy is evaluated.
• Viral factors like genotype, load, and kinetics are assessed for their impact on CHB treatment outcomes.

Purpose of the Study:

• To estimate the effect of viral factors on treatment response in CHB patients.
• To analyze the impact of HBV genotype, viral load, and kinetics during ADV therapy.
• To identify predictive markers for successful treatment outcomes in CHB.

Main Methods:

• Sixty-six CHB patients received adefovir dipivoxil (ADV) 10 mg QD.
• Quantitative HBV DNA and ALT levels were monitored at multiple time points up to 96 weeks.
• Nonresponse and viral resistance to ADV were defined by persistent viremia or viral rebound.

Main Results:

• Genotype D was most prevalent (66.7%), followed by A (27.3%) and E (6%).
• Virological response (VR) was achieved by 86.4% and biochemical response (BR) by 54.5% at week 48, with higher rates in genotype A patients.
• Early viral kinetics, particularly a rapid decline in viral load by week 12, strongly predicted sustained VR at week 96.

Conclusions:

• Early viral kinetics are critical for assessing treatment response in CHB.
• A rapid viral load decline at week 12 is a significant predictor of long-term virological response to ADV.
• ADV nonresponders at week 12 may require alternative antiviral strategies or drug switching.