title: Role of HBV genotype in predicting response to lamivudine therapy in patients with chronic hepatitis B.
abstract: BACKGROUND
  Predictors of response of chronic hepatitis B (CHB) to lamivudine therapy need better definition. Whether hepatitis B virus (HBV) genotypes could serve as such a predictor has not been well studied.
  
  
  OBJECTIVE
  To study the association of HBV genotypes with the outcome of lamivudine treatment in patients with CHB.
  
  
  METHODS
  Seventy-six patients with CHB (45 HBeAg +ve) received lamivudine 100 mg/day, orally for 12 mo. Infecting HBV genotypes were determined in pre-treatment specimens using restriction fragment length polymorphism. End-of-treatment response (ETR) and sustained viral response (SVR) were defined as undetectable HBV DNA (< 0.5 pg/mL) at 12 and 18 months, respectively.
  
  
  RESULTS
  ETR was observed in 26 (34%) and SVR in 11 (14%) patients receiving lamivudine. The pre-treatment characteristics of the responders and non-responders were comparable. Genotypes A and D were observed in 28 (37%) and 48 (63%) patients, respectively. The frequency of genotypes A and D was comparable between responders (28.6% vs. 37.5%) and non-responders (71.4% vs. 62.5%), respectively (p=ns). Of the 26 responders, SVR could be evaluated in 20 subjects; 9 (45%) relapsed and 11 achieved SVR. Patients with genotype D achieved higher SVR rate than genotype A (10 of 48, 28.8% vs. 1 of 28, 3.5% p =0.0359).
  
  
  CONCLUSIONS
  Forty-five percent of Indian patients with CHB who achieve ETR relapse, and SVR to lamivudine therapy is achieved in 14%. Patients with genotype D achieve higher SVR rate than with genotype A.
authors.affiliation: Department of Gastroenterology, G B Pant Hospital, New Delhi-110 002, India.
authors.forename: V
authors.initials: V
authors.lastname: Thakur
authors.forename: S K
authors.initials: SK
authors.lastname: Sarin
authors.forename: S
authors.initials: S
authors.lastname: Rehman
authors.forename: R C
authors.initials: RC
authors.lastname: Guptan
authors.forename: S N
authors.initials: SN
authors.lastname: Kazim
authors.forename: S
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D024882:Drug Resistance, Viral / Q000235:genetics*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D006513:Hepatitis B e Antigens; D019259:Lamivudine