title: High treatment modification rates with lamivudine therapy in HBV-infected patients with low baseline viremia and early virological response: A multicenter study.
abstract: OBJECTIVE
  Low baseline viremia and an early treatment response predict the best outcomes in hepatitis B virus (HBV)-infected patients treated with nucleoside analogues with low barriers to resistance. The aim of this study was to assess the long-term results and effectiveness of lamivudine in patients with low baseline viremia and early virological treatment response.
  
  
  METHODS
  In this multicenter, real-life setting study, 111 antiviral-naive patients with low baseline viremia (HBV DNA <10(7) copies/mL) plus an early virological response (HBV DNA <300 copies/mL at week 24) treated with lamivudine were enrolled. The primary end-point was treatment failure, defined as the re-emergence of detectable viremia or at least a 1 log increase in HBV DNA, resulting in a titer of ≥ 300 copies/mL with lamivudine treatment after week 24, which required treatment modification.
  
  
  RESULTS
  Altogether 111 patients, including 78 non-cirrhotic and 33 cirrhotic patients, were included in the study. Treatment failure occurred in 30.8% of the non-cirrhotic patients over a median follow-up period of 32.5 months, and the 1-, 2-, 3-, 4- and 5-year treatment failure rates were 6.5%, 14.0%, 31.4%, 39.6% and 43.1%, respectively. Treatment failure occurred in 28.8% of the whole group. There were no differences between the cirrhotic and non-cirrhotic patients.
  
  
  CONCLUSIONS
  Lamivudine treatment had a high treatment modification rate in patients with low baseline viremia and early virological response over a long-term follow-up in a real-life setting. The pretreatment and on-treatment favorable characteristics found in the studies with telbivudine appeared to be inapplicable to lamivudine.
authors.affiliation: Department of Gastroenterology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Gonen
authors.affiliation: Department of Gastroenterology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Feyza
authors.initials: F
authors.lastname: Gunduz
authors.affiliation: Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Doganay
authors.affiliation: Medeniyet University Medical School, Istanbul, Turkey.
authors.forename: Feruze Y
authors.initials: FY
authors.lastname: Enc
authors.affiliation: Marmara University Medical School, Istanbul, Turkey.
authors.forename: Ender G
authors.initials: EG
authors.lastname: Yegin
authors.affiliation: Kartal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Emel
authors.initials: E
authors.lastname: Ahishali
authors.affiliation: Department of Gastroenterology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Emrullah
authors.initials: E
authors.lastname: Erdem
authors.affiliation: Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sokmen
authors.affiliation: Medeniyet University Medical School, Istanbul, Turkey.
authors.forename: Ilyas
authors.initials: I
authors.lastname: Tuncer
authors.affiliation: Marmara University Medical School, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Ozdogan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral; D005260:Female; D006515:Hepatitis B virus / Q000187:drug effects*; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014766:Viremia / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D019259:Lamivudine
keywords: early response; hepatitis B virus; lamivudine; resistance; viral load