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Until recently, interferon and lamivudine were the only proven therapies for chronic hepatitis B virus (HBV) infection. But, many patients cannot tolerate interferon, and drug resistance develops frequently with lamivudine. Now we have a third option, the nucleotide analogue adefovir dipivoxil (Hepsera), which was evaluated in these 2 industry-sponsored, multicenter, randomized trials.
In one trial, 515 hepatitis B e-antigen-positive viremic patients received daily oral doses of adefovir (30 mg or 10 mg) or placebo. At 48 weeks, patients in both adefovir groups were significantly more likely than patients in the placebo group to have histologic improvement on liver biopsy (59% and 53% vs. 25%), undetectable serum HBV DNA levels (39% and 21% …