Efficacy of lamivudine on hepatitis B viral status and liver function in patients with hepatitis B virus-related hepatocellular carcinoma.
OBJECTIVE
Treatment of patients with hepatocellular carcinoma (HCC) depends on the tumour extent and underlying liver function. Antiviral therapy with nucleoside/nucleotide analogues has been shown to be effective in improving the liver function of chronic hepatitis B (CHB) patients. We assessed whether lamivudine could induce biochemical and virological improvements in patients with hepatitis B virus-related HCC.


METHODS
Of 148 CHB patients treated with 100 mg/day lamivudine for at least 6 months, 80 had HCC (CHB/HCC group) and 68 did not (CHB group). Biochemical and virological parameters were serially monitored.


RESULTS
Compared with the CHB group, the CHB/HCC group was older, had higher male predominance, bilirubin levels and liver cirrhosis rate, and lower albumin and hepatitis B virus (HBV) DNA levels and hepatitis B e antigen (HBeAg) positivity (P<0.05 each). The two groups showed similar cumulative rates of alanine aminotransferase normalization, HBV DNA seroconversion, HBeAg loss and viral breakthrough during 12 months of lamivudine treatment. After 12 months, the CHB/HCC group showed, relative to baseline, increased albumin levels (3.51+/-0.5 vs. 3.72+/-0.5 mg/ml) and decreased ascites scores (1.63+/-0.7 vs. 1.45+/-0.6) and Child-Pugh scores (6.92+/-1.9 vs. 6.02+/-1.38) (P<0.05 each).


CONCLUSIONS
Lamivudine had comparable antiviral effects both in patients with CHB and CHB/HCC, and improved underlying liver function in the latter group. Treatment of HBV may increase the chance of curative treatments in patients with HBV-related HCC.
Kim
Ji Hoon
JH
Center for Liver Cancer, National Cancer Center, Goyang, Korea.
Park
Joong-Won
JW
Koh
Dong Wook
DW
Lee
Woo Jin
WJ
Kim
Chang-Min
CM
D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000821:virology*; D005260:Female; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D007723:Korea; D019259:Lamivudine / Q000494:pharmacology* / Q000627:therapeutic use; D008099:Liver / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000998:Antiviral Agents; D019259:Lamivudine