Lamivudine treatment in patients with hepatitis B virus induced liver cirrhosis.
OBJECTIVE
First studies have suggested a beneficial effect of lamivudine in patients with cirrhosis caused by replicating hepatitis B virus. Whether long-term lamivudine therapy is effective in HBV-related liver cirrhosis patients was prospectively evaluated.


METHODS
Thirty-one patients with hepatitis B virus-related compensated/decompensated cirrhosis, all with quantitative DNA +ve by hybridization (10 HBeAg +ve, 21 anti-HBe +ve), received lamivudine 100 mg/day for average 16.3 (4-34) months.


RESULTS
At the end of therapy HBeAg seroconversion was observed in one patient. HBV DNA lost in all patients except two. Albumin levels increased (p<0.05). ALT levels and Child-Pugh-Turcotte scores decreased (p<0.05). Any complication related with liver cirrhosis was not observed during treatment period despite spontaneous ascitic infection in one and hepatic coma in two were occurred before therapy. Only one patient had clinical breakthrough presented by increase in ALT levels and reappearing of HBV DNA during therapy.


CONCLUSIONS
In patients with cirrhosis caused by replicating hepatitis B virus, prolonged therapy with lamivudine is well tolerated and resulted in improved serum biochemical values and loss of HBV DNA. Clinical improvements may also occur.
Cetin
Karaca
K
Istanbul University, Istanbul School of Medicine, Gastroenterology Dept, Istanbul, Turkey.
Sabahattin
Kaymakoglu
K
Kadir
Demir
D
Ahmet
Danalioglu
D
Ziyaettin
Durakoglu
D
Selim
Badur
B
Mürüvvet
Bozaci
B
Fatih
Besisik
B
Güngör
Boztas
B
Zeynel
Mungan
M
Yilmaz
Cakaloglu
C
Atilla
Okten
O
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome
D004279:DNA, Viral; D018894:Reverse Transcriptase Inhibitors; D012709:Serum Albumin; D019259:Lamivudine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin