Korean J Gastroenterol.  2003 Oct;42(4):303-312.

Predictive Factors and Efficacy of Lamivudine Treatment in Chronic Hepatitis B Infection

• Park NH
• Shin JW
• Park JH
• Bang SJ
• Kim DH
• Joo KR
• Kim DH

Abstract

BACKGROUND/AIMS: Lamivudine, an oral nucleoside analogue, effectively suppresses hepatitis B virus (HBV) replications and improves liver enzymes as well as liver histology. The aim of this study was to evaluate the effectiveness of lamivudine and the patient-dependent or laboratory variables that predict HBeAg seroconversion.
METHODS
We retrospectively analyzed 519 consecutive patients with HBeAg-positive chronic hepatitis B who were treated with lamivudine. The duration of lamivudine therapy was from 6 to 64 months (mean 20 months).
RESULTS
The HBeAg seroconversion was achieved in 192 patients (37%). The cumulative HBeAg seroconversion rates were 28% at 12 months, 39% at 24 months, 49% at 36 months, and 53% at 48 months. The predictive factors of lamivudine-induced HBeAg seroconvresion were the changing patterns of quantitative HBeAg level during lamivudine therapy, pretreatment quantitative HBeAg levels, ALT levels, and the duration of lamivudine therapy. One hundred eighty-three patients who had achieved HBeAg seroconversion showed patterns that HBeAg levels were continuously decreased. Therapy was discontinued after HBeAg seroconversion in 121 patients. Sixty-six patients experienced a relapse during the follow-up period (mean 8.9 months).
CONCLUSIONS
The continuously decreasing patterns of quantitative HBeAg levels during lamivudine therapy can predict HBeAg seroconversion in clinical settings.

Keyword

Hepatitis B; chronic; Lamivudine; Predictive factors; Quantitative HBeAg levels; Relapse

MeSH Terms

Adolescent
Adult
Aged
Antiviral Agents/*therapeutic use
Female
Hepatitis B e Antigens/blood
Hepatitis B, Chronic/*drug therapy/virology
Humans
Lamivudine/*therapeutic use
Male
Middle Aged
Retrospective Studies
Treatment Outcome