title: Individual prediction model for lamivudine treatment response in hepatitis B virus e antigen-positive chronic hepatitis B patients.
abstract: OBJECTIVE
  Although prolonged lamivudine (LAM) therapy is associated with the emergence of LAM-resistant mutations, it is still a commonly used therapy in many Asian countries because of its established long-term safety and low cost. The aim of our study was to assess the predictors of long-term LAM treatment response and to establish an individual prediction model (IPM) for hepatitis B virus e antigen (HBeAg) seroconversion in HBeAg-positive chronic hepatitis B (CHB) patients.
  
  
  METHODS
  This was a multicenter analysis of 838 patients treated with LAM between January 1999 and August 2004. Of these, 748 patients were followed up for at least 24 months.
  
  
  RESULTS
  The median age was 43.0 years (range, 19-79 years) and the mean duration of LAM monotherapy was 34.2 ± 0.7 months. In the multivariate analysis, age (odds ratio [OR] = 0.974, P < 0.001), baseline alanine aminotransferase level (OR = 1.001, P = 0.014), and baseline hepatitis B virus DNA level (OR = 0.749, P < 0.001) were independent factors for HBeAg seroconversion. Based on the predictors, an IPM was established. Patients were classified into high (> 50%), intermediate (30-50%), or low (≤ 30%) response groups based on their probability of HBeAg seroconversion according to the IPM. The cumulative HBeAg seroconversion rate at 6 years for the high, intermediate, and low response groups was 66.0%, 48.5%, and 21.8%, respectively (P < 0.001).
  
  
  CONCLUSIONS
  An IPM was developed based on predictors of HBeAg seroconversion in HBeAg-positive CHB patients on LAM monotherapy. This model will allow screening of LAM responders prior to the commencement of antiviral treatment.
authors.affiliation: Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea; Liver Cirrhosis Clinical Research Center, Seoul, Korea.
authors.forename: Hyun Woong
authors.initials: HW
authors.lastname: Lee
authors.forename: Wonseok
authors.initials: W
authors.lastname: Kang
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Heon Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Hwang
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Ki Jun
authors.initials: KJ
authors.lastname: Han
authors.forename: Ja Kyung
authors.initials: JK
authors.lastname: Kim
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Yong Han
authors.initials: YH
authors.lastname: Paik
authors.forename: Chun Kyon
authors.initials: CK
authors.lastname: Lee
authors.forename: Ik-Seong
authors.initials: IS
authors.lastname: Choi
authors.forename: Kwan Sik
authors.initials: KS
authors.lastname: Lee
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005544:Forecasting; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006513:Hepatitis B e Antigens; D019259:Lamivudine
keywords: chronic hepatitis B; lamivudine; treatment