Pediatr Infect Vaccine.  2018 Aug;25(2):72-81. 10.14776/piv.2018.25.e2.

Therapeutic Efficacy of Lamivudine in Children and Adolescents with Chronic Hepatitis B

• Choi Y
• Bae KS
• Kim KH
• Koh DK
• Kim JH

• KMID: 2418539
• DOI: http://doi.org/10.14776/piv.2018.25.e2

Abstract

PURPOSE
This prospective study aimed to investigate the therapeutic efficacy of lamivudine in children with chronic hepatitis B virus (HBV) infection.
METHODS
During July 2003 through October 2015, children with chronic hepatitis B who visited our institution were included in this study. Fifty-five patients, who received first-line treatment of lamivudine (3 mg/kg, 100 mg maximum) for over three months, were enrolled. After initiating lamivudine, alanine aminotransferase (ALT), HBV-DNA, and HBV markers were followed up at 1 month, 3 months, and every 3 months, thereafter. The treatment endpoint was determined as 1) normalization of ALT, 2) HBeAg seroconversion, and 3) anti-HBe positivity for twelve consecutive months.
RESULTS
Thirty-one male (56.4%) and 24 female (43.6%) patients were included. The mean age at treatment initiation was 8.1 years. The mean duration of treatment was 23.4 months. ALT normalization was found in 98.2% (54 of 55). Anti-HBe seroconversion was found in 70.6% (36/51). Loss of HBsAg was found in 10.9% (6/55). All biochemical responses occurred under age seven. The rate of virologic response (defined as HBV-DNA <2,000 IU/mL) at six months after treatment initiation was 78.7% (37/47). At twelve months after reaching treatment endpoint, 87.2% (34/39) maintained their virologic response. Resistance to lamivudine was found in 16.4% (9/55).
CONCLUSIONS
Lamivudine treatment in Korean pediatric patients with chronic hepatitis B showed better outcomes compared with other studies that implemented similar protocols in foreign populations. Further studies are needed to investigate the efficacy of newly recommended antiviral drugs on the Korean pediatric population.

Keyword

Chronic hepatitis B; Antiviral agents; Lamivudine; Child; Adolescent

MeSH Terms

Adolescent*
Alanine Transaminase
Antiviral Agents
Child*
Female
Hepatitis B e Antigens
Hepatitis B Surface Antigens
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Lamivudine*
Male
Prospective Studies
Seroconversion
Alanine Transaminase
Antiviral Agents
Hepatitis B Surface Antigens
Hepatitis B e Antigens
Lamivudine

Figure

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  Fig. 1 Follow-up schedule of the subjects who were enrolled in this study.

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  Fig. 2 Cumulative proportion of HBeAg seroconversion and HBsAg clearance during the follow-up period as calculated by Kaplan-Meier test.

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  Fig. 3 Cumulative proportion of HBeAg seroconversion during the follow-up period as calculated by Kaplan-Meier test.

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