Liver histology of Asian patients with chronic hepatitis B on prolonged lamivudine therapy.
BACKGROUND
Long-term effect of YMDD mutations on liver histology in Chinese hepatitis B patients is unknown.


OBJECTIVE
To examine the effect of prolonged lamivudine treatment on liver histology in Chinese patients with and without YMDD mutations.


METHODS
Liver histology was assessed in 85 patients on long-term lamivudine at baseline and year 1, and at year 3 for 25 patients.


RESULTS
Comparing patients with and without YMDD mutations at year 1, the former had higher baseline median necroinflammatory (11 vs. six respectively, P = 0.014) and fibrosis scores (three vs. one respectively, P = 0.001). The proportion of patients with improvement in necroinflammation and worsening of fibrosis was comparable for patients with and without YMDD mutations at year 1 (57.1%, 14.3% vs. 55%, 15% respectively) and year 3 (57.9%, 26.3% vs. 50%, 16.7% respectively). Comparing the histology at year 1 and 3, more patients with YMDD mutations developing after year 1 had worsening of necroinflammation than patients with persistent YMDD wild type (53.8% vs. 25% respectively).


CONCLUSIONS
Patients who developed YMDD mutations had higher baseline histological scores. With YMDD mutations, the liver histology became less favourable after 3 years than at the first year, although there was still improvement when compared with that at baseline.
Yuen
M-F
MF
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China. mfyuen@hkucc.hku.hk
Chow
D H-F
DH
Tsui
K
K
Wong
B C-Y
BC
Yuen
J C-H
JC
Wong
D K-H
DK
Lai
C-L
CL
D000293:Adolescent; D000328:Adult; D044466:Asian People / Q000235:genetics*; D001706:Biopsy / Q000379:methods; D002681:China / Q000208:ethnology; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*
D004279:DNA, Viral; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine