title: Long-term results of lamivudine monotherapy in Korean patients with HBeAg-positive chronic hepatitis B: response and relapse rates, and factors related to durability of HBeAg seroconversion.
abstract: OBJECTIVE
  The aim of this study was to evaluate retrospectively the long-term effects of lamivudine in 461 Korean patients with chronic hepatitis B who were treated for more than 12 months.
  
  
  METHODS
  The annual rates of virological response and breakthrough were examined and the predictive factors for post-treatment relapse in 114 patients who achieved hepatitis B e antigen (HBeAg) loss or seroconversion after lamivudine therapy were also analyzed.
  
  
  RESULTS
  During follow-up, the rates of HBeAg seroconversion after 1, 2, 3, 4 and 5 years of treatment were 22.9, 33.2, 47.6, 54.2 and 58.8%, respectively, while those for virological breakthrough at 1, 2, 3 and 4 years were 8.2, 41.7, 55.7 and 64.8%, respectively. Ninety-five patients (20.6%) had HBeAg seroconversion and 19 (4.1%) showed HBeAg loss alone with disappearance of hepatitis B virus DNA in serum. Seroconversion was higher with prolonged treatment in patients who had elevated serum alanine aminotransferase. The cumulative relapse rates in the seroconversion group were 52.0 and 55.7% 1 and 2 years after treatment, respectively. Age and the duration of additional treatment were significant predictive factors for post-treatment relapse. Patients aged </=40 who had additional treatment for >12 months after seroconversion had the lowest relapse rate (p < 0.001).
  
  
  CONCLUSIONS
  These results suggest that additional treatment for over 12 months after HBeAg seroconversion in younger patients may produce a better long-term outcome.
authors: Department of Internal Medicine and WHO Collaborating Center for Reference and Research on Viral Hepatitis, College of Medicine, Catholic University of Korea, Seoul, South Korea. yoonsk@catholic.ac.kr
authors: Seung Kew
authors: SK
authors: Yoon
authors: Jeong Won
authors: JW
authors: Jang
authors: Chang Wook
authors: CW
authors: Kim
authors: Si Hyun
authors: SH
authors: Bae
authors: Jong Young
authors: JY
authors: Choi
authors: Sang Wook
authors: SW
authors: Choi
authors: Young Sok
authors: YS
authors: Lee
authors: Chang Don
authors: CD
authors: Lee
authors: Kyu Won
authors: KW
authors: Chung
authors: Hee Sik
authors: HS
authors: Sun
authors: Boo Sung
authors: BS
authors: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D007723:Korea; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D000410:Alanine Transaminase