Pediatr Gastroenterol Hepatol Nutr.  2013 Jun;16(2):80-88.

Current Role of Lamivudine Regarding Therapeutic Response and Resistance in Children with Chronic Hepatitis B

• Hong SJ
• Kim YH
• Choe BH
• Park HJ
• Tak WY
• Kweon YO

Abstract

PURPOSE
To identify the predictive factors of long-term therapeutic response or resistance to lamivudine treatment in children and adolescents with chronic hepatitis B.
METHODS
Eighty one children and adolescents with chronic hepatitis B were included, who received lamivudine treatment for at least 6 months. Their condition was monitored for at least 12 months (12-88 months) thereafter. Twenty one (25.9%) were preschool children (age< or =6). For patients who had developed HBeAg seroconversion or breakthrough, univariate and multivariate analyses were used to identify the effects of age, gender, pretreatment alanine aminotransferase (ALT) and hepatitis B virus DNA levels.
RESULTS
HBeAg seroconversion occurred in 49 (60.5%) of the 81 patients after the initiation of the lamivudine therapy. In 65 patients whom were monitored for over 24 months, the seroconversion rate was significantly higher in younger patients (p=0.040), especially in those patients of preschool age (age< or =6, p=0.031). The seroconversion rate was significantly higher in higher pretreatment ALT (p=0.003). The breakthrough occurred in 21 (25.9%) of the 81. The breakthrough rate was lower in younger aged patients (age< or =6), and with higher pretreatment ALT levels, but no significant difference.
CONCLUSION
Younger age is a good predictor of HBeAg seroconversion in children with long-term lamivudine treatment as well as high pretreatment ALT levels.

Keyword

Chronic hepatitis; Child; Lamivudine; Seroconversion; Therapeutics

MeSH Terms

Adolescent
Aged
Alanine Transaminase
Child
Child, Preschool
DNA
Hepatitis B e Antigens
Hepatitis B virus
Hepatitis B, Chronic
Hepatitis, Chronic
Humans
Lamivudine
Multivariate Analysis
Alanine Transaminase
DNA
Hepatitis B e Antigens
Lamivudine

Figure

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  Fig. 1 Algorithm of treatment for HBeAg (+) chronic hepatitis B. Analysis was done for 81 and 65 patients who have followed-up for over 12 months and 24 months, respectively. ×ULN: times the upper limit of the normal range, f/u: follow-up.

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