Response of pre-core mutant chronic hepatitis B infection to lamivudine.
The proportion of chronic liver disease associated with the pre-core mutant of hepatitis B virus (HBV) infection is increasing, particularly in Mediterranean Europe and in Asia. The pre-core mutant HBV is unable to produce hepatitis B e antigen (HBeAg), so that patients with this variant do not present with HBV characterised by HBeAg in the serum. Pre-core mutant chronic hepatitis B infection usually proceeds to serious liver disease. Wild-type HBV infection may be mild and respond relatively well to interferon (IFN) alpha therapy, but IFN alpha is not an effective therapeutic option in pre-core mutant hepatitis B infection and new therapeutic options are needed. Clinical data show that lamivudine is an effective treatment for patients with pre-core mutant hepatitis B. There is profound suppression of HBV replication and improvement in indicators of liver disease in most patients. In conclusion, lamivudine is suitable for treatment of a wide range of patients with chronic hepatitis B, including those with pre-core mutant HBV infection.
Rizzetto
M
M
Dipartimento di Gastroenterologia, Azienda Ospedaliera S. Giovanni Battista, Università di Torino, Torino, Italy.
Volpes
R
R
Smedile
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D004311:Double-Blind Method; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D009154:Mutation; D011498:Protein Precursors / Q000235:genetics; D016896:Treatment Outcome; D014758:Viral Core Proteins / Q000235:genetics*
D000998:Antiviral Agents; D004279:DNA, Viral; D011498:Protein Precursors; D014758:Viral Core Proteins; D019259:Lamivudine; D000410:Alanine Transaminase