The Histological Changes of the Liver after Three Years of Lamivudine Treatment in Patients with Chronic Hepatitis B

Jung, Eun Sun; Bae, Si Hyun; Jang, Jeong Won; Choi, Jong Young; Yoon, Seung Kew; Chung, Kyu Won; Sun, Hee Sik; Park, Doo Ho; Kim, Byung Ki

Abstract

BACKGROUND/AIMS: The aim of this study was to examine the histological changes of the liver after a 3-year lamivudine therapy in patients with chronic hepatitis B. METHODS: Seven patients with sustaining virological and biochemical response were enrolled in this study. The patients were given lamivudine orally at a dose of 100 mg for 3 years, and then, the second liver biopsy was performed. The liver biopsies were evaluated using the conventional histological assessment scale and the quantification of fibrosis by an image analysis. RESULTS: All patients showed a reduction in the hepatic necro-inflammatory activity after 3 years of lamividine therapy compared to the pretreatment value as follows: the mean grade of lobular activity, 1.14 vs. 2.28; porto-periportal activity grade, 1 vs. 2.57; fibrosis stage 1.14 vs. 2.14. The quantification by the image analysis showed a significant reduction of the fibrotic area in the mean portal, periportal, and septal portions (17,985 vs. 7,082 um2, p<0.05). The intrahepatic expression of HBcAg turned negative in the liver tissues of five patients. CONCLUSIONS: The improvements in liver histology, especially in porto-periportal activity and fibrosis, can be obtained in patients with sustained viral and biochemical response after a long-term lamivudine treatment.