title: Early virological response predicts outcome during extended lamivudine retreatment in patients with chronic hepatitis B who relapsed after initial HBeAg responses.
abstract: OBJECTIVE
  Studies from hepatitis B virus endemic areas have shown less durable lamivudine-induced responses and have raised issues about the management of a post-treatment relapse.
  
  
  METHODS
  From January 2000 to June 2004, all 51 patients (43 HBeAg-positive and eight HBeAg-negative) were retreated with lamivudine for at least 12 months. All had a post-treatment relapse after HBeAg responses (HBeAg loss/seroconversion) during the first therapy.
  
  
  RESULTS
  During retreatment, HBeAg seroconversion occurred more frequently in those patients with HBeAg seroconversion than in those with HBeAg loss alone during prior lamivudine therapy (P = 0.001). On multivariate analysis, prior HBeAg seroconversion and early virological response (EVR) (< or = 2 months of retreatment) independently predicted HBeAg seroconversion (P = 0.012 and P = 0.004, respectively). With regard to virological breakthrough, only the time to virological response (> 2 months of retreatment) remained significant (P = 0.048). Among the HBeAg-negative patients, virological breakthrough occurred in only one patient with a late virological response.
  
  
  CONCLUSIONS
  EVR is a major predictor in determining a favorable response to lamivudine retreatment. Our observations suggest that lamivudine retreatment will provide more therapeutic gains in those patients with a prior HBeAg seroconversion than in those with HBeAg loss alone.
authors.affiliation: Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jeong Won
authors.initials: JW
authors.lastname: Jang
authors.forename: Si Hyun
authors.initials: SH
authors.lastname: Bae
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Kim
authors.forename: Nam Ik
authors.initials: NI
authors.lastname: Han
authors.forename: Jun Yeol
authors.initials: JY
authors.lastname: Han
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Choi
authors.forename: Seung Kew
authors.initials: SK
authors.lastname: Yoon
authors.forename: Kyu Won
authors.initials: KW
authors.lastname: Chung
authors.forename: Hee Sik
authors.initials: HS
authors.lastname: Sun
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length; D019233:Retreatment; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine