Influence of the hepatitis B e antigen/anti-HBe status on the response to lamivudine.
OBJECTIVE
The optimal therapeutic regimen of lamivudine for chronic hepatitis B is not agreed upon, especially with reference to hepatitis B e antigen (HBeAg) or the corresponding antibody (anti-HBe) in sera of patients.


METHODS
We analyzed 249 Japanese patients with chronic HBV infection who were treated with lamivudine for more than 12 months. HBeAg was detected in sera from 117 of them (47%). HBV DNA sequences in serum samples from the pretreatment period and during therapy were amplified by polymerase chain reaction, and analyzed for mutations.


RESULTS
Lamivudine normalized serum levels of alanine aminotransferase at 6 and 12 months, and suppressed serum HBV DNA to levels undetectable by the bDNA method in most patients. Lamivudine suppressed HBV DNA levels to a greater extent in patients with anti-HBe than HBeAg. In patients treated with lamivudine for 5 years, HBV mutants with mutations in the precore region and core promoter reverted to the wild-type in some of them within 1 year.


CONCLUSIONS
Lamivudine induces a better response in patients without than in those with HBeAg. It initially selects the wild-type HBV from among precore or core promoter mutants.
Suzuki
Fumitaka
F
Department of Gastroenterology, Toranomon Hospital, 2-2-2, Minato-ku, Tokyo 105-8470, Japan. fumitakas@toranomon.gr.jp
D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000032:analysis; D006510:Hepatitis B Antibodies / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood* / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D011401:Promoter Regions, Genetic; D014758:Viral Core Proteins / Q000235:genetics
D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; D014758:Viral Core Proteins; D019259:Lamivudine