Lamivudine treatment in maternally transmitted chronic hepatitis B virus infection patients.
BACKGROUND
Lamivudine treatment in chronic carriers who acquired hepatitis B virus through maternal transmission were investigated.


METHODS
A total of 29 subjects (Male:Female, 24:5; mean age, 14.7 +/- 5.6 years) who were hepatitis B e antigen (HBeAg) seropositive for >6 months, alanine aminotransferase (ALT) was >1.3 times of upper limit of normal value, and receiving a 52 week-long treatment, received open-label lamivudine (3 mg/kg per day, maximum 100 mg/day). Another 29 subjects matched for gender, age, liver function, and HBeAg status followed up before the introduction of lamivudine served as the control group. The control group did not receive any treatment and were evaluated at week 52 after the onset of abnormal ALT. Mothers of all study subjects were hepatitis B surface antigen (HBsAg) carriers. A successful treatment response at week 52 was defined as: (i) undetectable hepatitis B virus DNA by real time polymerase chain reaction; (ii) normal ALT; and (iii) HBeAg/anti-HBe seroconversion. Lamivudine-resistant YMDD mutants were checked at week 52.


RESULTS
The lamivudine group did not reach a better successful treatment response rate than the control group (17 vs 10%, P = 0.44), except in patients with a baseline ALT >5 times of the upper limit of normal value. YMDD mutants developed in 34% of patients in the lamivudine group.


CONCLUSIONS
Lamivudine treatment is effective for maternally transmitted subjects with high ALT.
Ni
Yen-Hsuan
YH
Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan.
Huang
Fu-Chen
FC
Wu
Tzee-Chung
TC
Kong
Man-Shan
MS
Jeng
Yung-Ming
YM
Chen
Pei-Jer
PJ
Tsuei
Daw-Jen
DJ
Chen
Huey-Ling
HL
Hsu
Hong-Yuan
HY
Chang
Mei-Hwei
MH
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D016133:Polymerase Chain Reaction
D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D019259:Lamivudine