[Predictive factors and efficacy of lamivudine treatment in chronic hepatitis B infection].
OBJECTIVE
Lamivudine, an oral nucleoside analogue, effectively suppresses hepatitis B virus (HBV) replications and improves liver enzymes as well as liver histology. The aim of this study was to evaluate the effectiveness of lamivudine and the patient-dependent or laboratory variables that predict HBeAg seroconversion.


METHODS
We retrospectively analyzed 519 consecutive patients with HBeAg-positive chronic hepatitis B who were treated with lamivudine. The duration of lamivudine therapy was from 6 to 64 months (mean 20 months).


RESULTS
The HBeAg seroconversion was achieved in 192 patients (37%). The cumulative HBeAg seroconversion rates were 28% at 12 months, 39% at 24 months, 49% at 36 months, and 53% at 48 months. The predictive factors of lamivudine-induced HBeAg seroconvresion were the changing patterns of quantitative HBeAg level during lamivudine therapy, pretreatment quantitative HBeAg levels, ALT levels, and the duration of lamivudine therapy. One hundred eighty-three patients who had achieved HBeAg seroconversion showed patterns that HBeAg levels were continuously decreased. Therapy was discontinued after HBeAg seroconversion in 121 patients. Sixty-six patients experienced a relapse during the follow-up period (mean 8.9 months).


CONCLUSIONS
The continuously decreasing patterns of quantitative HBeAg levels during lamivudine therapy can predict HBeAg seroconversion in clinical settings.
Park
Neung Hwa
NH
Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea. nhpark@www.uuh.ulsan.kr
Shin
Jung Woo
JW
Park
Jong Ho
JH
Bang
Sung Jo
SJ
Kim
Dae-yun
DY
Joo
Kwang Ro
KR
Kim
Do Ha
DH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D019259:Lamivudine