title: The effectiveness of lamivudine treatment in cirrhotic patients with HBV precore mutations: a prospective, open-label study.
abstract: In this study, the effect of lamivudine therapy on viral suppression, Child-Pugh score, and survival was assessed in patients with decompensated cirrhosis due to precore mutant hepatitis B virus and the results were compared with those for nonreplicative cirrhotic patients. Twenty-three replicative patients who received lamivudine and 15 nonreplicative patients were included and followed up for an average of 23.7+/-13.4 months. At baseline, there were no significant differences between the groups with regard to clinical and biochemical parameters or Child-Pugh scores, except for serum alanine aminotransferase levels (P<0.05) and quantitative hepatitis B virus DNA measurements (P<0.001). Compared to baseline, there was no significant difference in Child-Pugh score in the lamivudine group at the last visit (P=0.202), whereas a marked increase was observed in nonreplicative patients (P=0.002). Mortality rates in the lamivudine and nonreplicative groups were 17.43% and 13.3%, respectively (P=0.556), and there was no difference in survival analysis (P=0.809). Lamivudine therapy stabilizing clinical situation in decompensated cirrhotics with precore mutation makes the natural history of the disease equal with nonreplicative decompensated cirrhotics or even provides some advantages over them.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Harran University, Sanliurfa, and Gastroenterology Clinic, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. drcengizbolukbas@hotmail.com
authors.forename: Cengiz
authors.initials: C
authors.lastname: Bolukbas
authors.forename: Fusun Filiz
authors.initials: FF
authors.lastname: Bolukbas
authors.forename: Tulin
authors.initials: T
authors.lastname: Kendir
authors.forename: Nihat
authors.initials: N
authors.lastname: Akbayir
authors.forename: Ali Tuzun
authors.initials: AT
authors.lastname: Ince
authors.forename: Evren
authors.initials: E
authors.lastname: Abut
authors.forename: Mehmet
authors.initials: M
authors.lastname: Horoz
authors.forename: Ali Remzi
authors.initials: AR
authors.lastname: Dalay
authors.forename: Mehmet Haci
authors.initials: MH
authors.lastname: Sokmen
authors.forename: Oya
authors.initials: O
authors.lastname: Ovunc
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000097:blood / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy; D006513:Hepatitis B e Antigens / Q000097:blood / Q000187:drug effects; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000187:drug effects*; D011446:Prospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine