Yonsei Med J.  2007 Dec;48(6):927-933. 10.3349/ymj.2007.48.6.927.

Lamivudine Therapy for Korean Children with Chronic Hepatitis B

• Koh H
• Baek SY
• Chung KS

• KMID: 1786205
• DOI: http://doi.org/10.3349/ymj.2007.48.6.927

Abstract

PURPOSE: Lamivudine is known to be very effective in suppressing hepatitis B virus replication and virus induced necroinflammation. The aim of this study was to evaluate lamivudine therapy efficacy, predictive factors, breakthrough, prevalence of YMDD mutation, and relapse rate in Korean children with chronic hepatitis B. MATERIALS AND METHODS: Between August 1999 and February 2005, 60 children on lamivudine therapy for chronic hepatitis B were enrolled. Treatment response was defined as alanine aminotransferase (ALT) normalization, and HBeAg and HBV-DNA disappearance. RESULTS: Seroconversion rates of HBeAg and HBV-DNA were 42% and 53%, respectively, and ALT normalization rate was 88%. Seroconversion rates of HBeAg (60.0%) and anti-HBe (60.0%) were higher in patients younger than 6 years. Seroconversion rate of HBV-DNA (68.4%) and normalization rate of serum ALT (94.7%) were highest in patients between 6 and 12 years. Seroconversion rates of all HBV markers were lowest in patients older than 12 years. Predicted 3 year cumulative seroconversion rates, were 70%, 68% for HBeAg, HBV-DNA, respectively. These were calculated by Kaplan-Meier method. Cox proportional hazard regression model showed that pre-treatment ALT was a positive predictive factor for seroconversion of HBeAg and HBV-DNA. Breakthrough phenomenon was noted in 6 patients, and 3 had a YMDD mutation. CONCLUSION: Lamivudine therapy had a significant effect on HBeAg seroconversion and HBV-DNA disappearance, and ALT normalization for Korean children with chronic hepatitis B.

Keyword

Chronic hepatitis B; lamivudine; children; HBeAg; HBV-DNA; pre-treatment ALT

MeSH Terms

Adolescent
Adult
Age Factors
Alanine Transaminase/blood
Anti-HIV Agents/therapeutic use
*Asian Continental Ancestry Group
Child
Cohort Studies
DNA, Viral/blood
Female
Hepatitis B e Antigens/blood
Hepatitis B virus/*drug effects/genetics/immunology
Hepatitis B, Chronic/blood/*drug therapy/ethnology
Humans
Korea
Lamivudine/*therapeutic use
Male
Sex Factors
Treatment Outcome

Figure

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  Fig. 1 Predictive cumulative rate of seroconversion of HBeAg analyzed by Kaplan-Meier method in patients with chronic hepatitis B. Approximately, a 70% seroconversion rate can be predicted at year 3.

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  Fig. 2 Predictive cumulative rate of seroconversion of HBeAg analyzed by Kaplan-Meier method in patients with chronic hepatitis B. Approximately, a 65% seroconversion rate can be predicted at year 3.

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  Fig. 3 Predictive cumulative rate of seroconversion of HBeAg analyzed by Kaplan-Meier method in patients with chronic hepatitis B. Approximately, a 68% seroconversion rate can be predicted at year 3.

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