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Favorable efficacy of long-term lamivudine therapy in patients with chronic hepatitis B: an 8-year follow-up study.

Abstract：

:The long-term efficacy of lamivudine therapy in patients with hepatitis B virus (HBV) infection is still not clear. In this study, 20 non-cirrhotic Japanese patients infected with HBV received lamivudine therapy for more than 1 year and were followed for a median period of 8.5 years (range, 6.7-8.7 years). The rates of HBe antigen (HbeAg) negative, HBV-DNA undetectable, and alanine aminotransferase (ALT) normal level at the start of lamivudine were 55%, 25%, and 20% and 85%, 80%, and were 80%, respectively, at the last visit, including patients who received additional treatment. The values at the last visit tended to and were significantly higher than those at the start. The values improved at the last visit regardless of the emergence of YMDD motif mutant and continuation of lamivudine. YMDD mutant and biochemical relapse with mutant virus (breakthrough hepatitis) appeared in 65% and 45% during follow-up, respectively, but severe breakthrough hepatitis occurred in only 5%. Furthermore, 80% of patients who received additional treatment for breakthrough hepatitis, regardless of continuation of lamivudine, were ALT normal level at the last visit, in contrast to 25% untreated. HBsAg clearance occurred in two patients of the discontinuous lamivudine group with non-vertical transmission, who were relatively young. One was infected with HBV genotype C with breakthrough hepatitis and the other had no YMDD mutant and was infected with genotype D, a rare type in Japan. None developed cirrhosis or hepatocellular carcinoma (HCC) during follow-up. Our results suggest that long-term lamivudine therapy improves long-term prognosis, especially when additional treatment for breakthrough hepatitis is used.

journal_name

J Med Virol

journal_title

Journal of medical virology

authors

Akuta N,Suzuki F,Suzuki Y,Sezaki H,Hosaka T,Someya T,Kobayashi M,Saitoh S,Arase Y,Ikeda K,Kobayashi M,Kumada H

doi

10.1002/jmv.20305

keywords:

subject

Has Abstract

pub_date

2005-04-01 00:00:00

pages

491-8

issue

4

eissn

0146-6615

issn

1096-9071

journal_volume

75

pub_type

临床试验,杂志文章

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