Long-term additional lamivudine therapy enhances durability of lamivudine-induced HBeAg loss: a prospective study.
OBJECTIVE
In the treatment of chronic hepatitis B (CHB) with lamivudine, adequate duration of the therapy remains to be determined. In this prospective study, the authors intended to investigate whether long-term additional administration of lamivudine might enhance the durability of lamivudine-induced HBeAg seroconversion.


METHODS
Eighty-five CHB patients who achieved HBeAg seroconversion by lamivudine received additional lamivudine therapy for at least 24 months at a dose of 100 mg per day. Among them, 61 patients whose serum HBeAg and HBV-DNA (solution hybridization assay) had been negative persistently for >24 months discontinued lamivudine therapy and followed-up for >12 months. We calculated the cumulative reappearance rate of serum HBV-DNA and HBeAg and also evaluated the predictive factors for post-treatment virologic relapse.


RESULTS
The cumulative reappearance rates of serum HBV-DNA following cessation of lamivudine therapy at 6 months, 1 year and 2 years were 15%, 21%, and 31%, respectively. The cumulative reappearance rates of serum HBeAg at 6 months, 1 year and 2 years were 11%, 13% and 16%, respectively. Old age and presence of precore mutant were two independent predictive factors for viral relapse.


CONCLUSIONS
These results suggested that long-term additional administration of lamivudine might enhance the durability of lamivudine-induced HBeAg seroconversion.
Ryu
Soo Hyung
SH
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong Songpa-ku, 138-040, Seoul, South Korea.
Chung
Young-Hwa
YH
Choi
Min Hee
MH
Kim
Jeong A
JA
Shin
Jung Woo
JW
Jang
Myoung Kuk
MK
Park
Neung Hwa
NH
Lee
Han Chu
HC
Lee
Yung Sang
YS
Suh
Dong Jin
DJ
D000328:Adult; D000375:Aging; D004279:DNA, Viral / Q000097:blood; D004334:Drug Administration Schedule; D005260:Female; D006513:Hepatitis B e Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage*; D012307:Risk Factors; D013997:Time Factors; D014758:Viral Core Proteins / Q000235:genetics
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D014758:Viral Core Proteins; D019259:Lamivudine