The Correlation Of Nucleos(T)IDE Analogues Adherence With The Occurrence Of Drug-resistant In Patients With Chronic Hepatitis B

ObjectiveMany researchers have discovered that poor adherence is one of thekey factors which induce drug-resistant in some deseasestreatment.Sametime the adherence is also involved in drug-resistant ofchronic hepatitis B(CHB) patients treated with nucleos(t)ideanalogues(NAs).This paper aims to determine to correlate NAs adherencewith the occurrence of drug-resistant in patients with CHB.MethodsThe926CHB patients suspected NAs resistant were from the SecondAffiliated of Chongqing Medical University from2009June to2013June.The sequence analysis of HBV DNA was performed.The data of thepatients were received by reviewing case history, follow-up(outpatient andcommunication) and analyzed. ResultsOf926patients suspected NAs resistant,729have genotypicmutations(729/926,78.73%).217of729patients with mutationshavecomplete case history record.148are male,69female, age are from13to78years old, mean40.84±6.53. Of217patients,135patie-nts(62.21%)received Lamivudine(LAM),51patients(23.50%) received Adefovir(ADV),24cases were Telbivudine(LDT),7cases were Entec-avir(ETV).65cases(65/217,29.95%) were alanine aminotransferase (ALT)<2times of the limitof normal upper (ULN)；57cases (57/217,26.27%) ALT2-5*ULN；27cases (27/217,12.44%)5-10*ULN； and68cases (68/217,31.34%)more than10*ULN.19cases were HBV-DNA negative(19/217,8.76%)；76cases HBV-DNA≤5log10copies/ml （76/217,35.02%），122casesHBV-DNA＞5log10copies/ml （122/217,18.43%）； the average ofHBV-DNA level is （5.31±1.12）log10copies/ml.Primary drug resistancewere17cases (17/217,7.83%);unreasonable medication124cases(124/217,57.14%);reasonable medication was63patients(63/217,29.03%);13cases reached the standard of the drug stopping(13/217,6.00%).ConclusionsAdherence is an important cause induceing NAs resistance in CHBpatients. The clinicians should pay attention to the patients with NAs treatment for reducing the risk of drug resistance.