title: Current role of Lamivudine regarding therapeutic response and resistance in children with chronic hepatitis B.
abstract: OBJECTIVE
  To identify the predictive factors of long-term therapeutic response or resistance to lamivudine treatment in children and adolescents with chronic hepatitis B.
  
  
  METHODS
  Eighty one children and adolescents with chronic hepatitis B were included, who received lamivudine treatment for at least 6 months. Their condition was monitored for at least 12 months (12-88 months) thereafter. Twenty one (25.9%) were preschool children (age≤6). For patients who had developed HBeAg seroconversion or breakthrough, univariate and multivariate analyses were used to identify the effects of age, gender, pretreatment alanine aminotransferase (ALT) and hepatitis B virus DNA levels.
  
  
  RESULTS
  HBeAg seroconversion occurred in 49 (60.5%) of the 81 patients after the initiation of the lamivudine therapy. In 65 patients whom were monitored for over 24 months, the seroconversion rate was significantly higher in younger patients (p=0.040), especially in those patients of preschool age (age≤6, p=0.031). The seroconversion rate was significantly higher in higher pretreatment ALT (p=0.003). The breakthrough occurred in 21 (25.9%) of the 81. The breakthrough rate was lower in younger aged patients (age≤6), and with higher pretreatment ALT levels, but no significant difference.
  
  
  CONCLUSIONS
  Younger age is a good predictor of HBeAg seroconversion in children with long-term lamivudine treatment as well as high pretreatment ALT levels.
authors.affiliation: Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Suk Jin
authors.initials: SJ
authors.lastname: Hong
authors.forename: Yeo Hyang
authors.initials: YH
authors.lastname: Kim
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Choe
authors.forename: Hyo Jung
authors.initials: HJ
authors.lastname: Park
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Tak
authors.forename: Young-Oh
authors.initials: YO
authors.lastname: Kweon
keywords: Child; Chronic hepatitis; Lamivudine; Seroconversion; Therapeutics