Beneficial effects of lamivudine in hepatitis B virus-related decompensated cirrhosis.
OBJECTIVE
HBV-related chronic liver disease patients often present with hepatic decompensation and are not eligible for interferon therapy. Whether long-term lamivudine is effective in these patients was prospectively evaluated.


METHODS
Eighteen patients with HBV-related decompensated cirrhosis, all with quantitative DNA +ve and 10 HBeAg +ve, were given lamivudine 150 mg/d.


RESULTS
Each patient received at least 9 months (mean 17.9) of lamivudine. Three HBeAg+ve patients (30%) seroconverted to anti-HBe and one lost HBsAg during the follow-up. An improvement from baseline in the aspartate aminotransferase (130 vs. 72 IU/l, p<0.04); alanine aminotransferase (111 vs. 58 IU/l, p<0.01) and Child-Pugh score (8.3 vs 6.7, p<0.013) was seen. Lamivudine had no significant side-effects. HBV DNA became undetectable in all patients by 8 weeks of therapy. In three (17%) patients, HBV DNA again became positive at 9, 9 and 27 months. YMDD mutant was, however, detected in only one (6%). A significant reduction was noted in the morbidity and hospitalizations for complications of liver disease before and after starting lamivudine (1.5+/-0.7 vs. 0.6+/-0.7, p<0.002).


CONCLUSIONS
In decompensated HBV-related cirrhosis, lamivudine: i) is effective in suppressing HBV DNA and seroconversion to anti-HBe (30%), ii) can achieve significant improvement in clinical and biochemical status of liver functions.
Kapoor
D
D
Department of Gastroenterology, G. B. Pant Hospital, New Delhi, India.
Guptan
R C
RC
Wakil
S M
SM
Kazim
S N
SN
Kaul
R
R
Agarwal
S R
SR
Raisuddin
S
S
Hasnain
S E
SE
Sarin
S K
SK
D000284:Administration, Oral; D000328:Adult; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine