title: Factors related to post-treatment relapse in chronic hepatitis B patients who lost HBeAg after lamivudine therapy.
abstract: OBJECTIVE
  It is uncertain if a patient's lamivudine response after HBeAg loss is durable. In Korean chronic hepatitis B patients, the relapse rate is high after termination of lamivudine therapy for patients with HBeAg loss. We evaluated the factors related to relapse in chronic hepatitis B patients with HBeAg loss after lamivudine therapy.
  
  
  METHODS
  A total of 132 chronic hepatitis B patients, who initially had HBeAg and did not have decompensated features, were analyzed in this study. These patients lost the HBeAg after lamivudine therapy and then their therapy was stopped. Post-treatment serum alanine aminotransferase (ALT), HBeAg, anti-HBe and hepatitis B virus (HBV) DNA were monitored until relapse.
  
  
  RESULTS
  Seventy-five patients relapsed (cumulative relapse rate: 56% at 6 months). Upon univariate analysis, the factors of age, serum total bilirubin, presence of anti-HBe after HBeAg loss, and the duration of additional lamivudine therapy after HBeAg loss were associated with relapse. Upon multivariate analysis, older age, a higher serum total bilirubin and the shorter duration of additional lamivudine therapy were significant risk factors for relapse. Patterns of relapse were the re-elevation of ALT, re-emergence of HBV DNA (69 patients) and reappearance of HBeAg (55 patients).
  
  
  CONCLUSIONS
  To prevent relapse in patients with chronic hepatitis B infection after lamivudine therapy, age and serum bilirubin level of patients as well as a prolonged duration of additional lamivudine therapy should be considered.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. kwsbyun@unitel.co.kr
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Byun
authors.forename: Oh Sang
authors.initials: OS
authors.lastname: Kwon
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Chang
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Kim
authors.forename: Jong Eun
authors.initials: JE
authors.lastname: Yeon
authors.forename: Jong Jae
authors.initials: JJ
authors.lastname: Park
authors.forename: Jae Seon
authors.initials: JS
authors.lastname: Kim
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Bak
authors.forename: Chang Hong
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D019259:Lamivudine / Q000008:administration & dosage*; D008111:Liver Function Tests; D008297:Male; D016016:Proportional Hazards Models; D012008:Recurrence; D019233:Retreatment; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D019259:Lamivudine