[Treatment response to lamivudine in chronic hepatitis B patients].
OBJECTIVE
The main objective was to find a biochemistry and virology response in positive and negative HBeAg patients who had been treating with lamivudine. Furthermore, the secondary objective was to make a description about kidney function changes that could be found in patients under treatment with lamivudine.


METHODS
Thirty patients with chronic B hepatitis under treatment with lamivudine had been retrospectively studied since November 1999 to March 2004, in a Digestive Unit, in Ciudad Real Hospital.


RESULTS
Twenty nine out of 30 patients were included, 8 out of 29 were positive HBeAg, and 21 out of 29 were negative HBeAg. Seven patients had been treated with IFN. Thus, 8 patients had been in need of adefovir treatment after lamivudine trial. The average of treatment had been 23.7 months (3 months-46 months). In fact, none of them were changed from positive HBsAg to negative HBsAg. Nevertheless, we have observed those results after lamivudine treatment. Firstly, 50% positive HBe Ag patients have carried on negative DNA results. Although 25% positive HBe Ag patients had converted to negative HBe Ag. But they did not show any anti HBe. Secondly, 76% negative HBe Ag patients had been suffering a DNA decreased, even though some of them had had a negative DNA results. Thirdly, we found some lamivudine mutation (50% in positive HBe Ag patients and 19% in negative HBe Ag patients). Finally, all the patients with negative DNA had maintained a normal AST and ALT levels. Thus, function renal had been normal under lamivudine trial.


CONCLUSIONS
According to several authors, the response to lamivudine treatment had been adequate in our population. Nevertheless, our study have shown that antiHBe levels had not been suffering any change during lamivudine treatment. In addition, we have found a smaller figures (19%) of lamivudine mutations in negative HBe Ag patients than other studies (25% in patients who were followed up for 1 year).
Mañas García
M D
MD
Servicio de Medicina Interna, Complejo Hospitalario, Ciudad Real. meiga12@yahoo.es
Domper Bardají
F
F
Hernández Albújar
A
A
Piqueras Alcol
B
B
Carpintero Briones
P
P
D000328:Adult; D000368:Aged; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007668:Kidney / Q000187:drug effects; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine