Extended lamivudine treatment in patients with chronic hepatitis B enhances hepatitis B e antigen seroconversion rates: Results after 3 years of therapy

By N. Leung, C. Lai, T. Chang, R. Guan, C. M. Lee, K. Ng, S. Lim, P. Wu, J. Dent, S. Edmundson and 2 more. Hepatology, 2001

663 citations recorded by the source corpus.

A study in Chinese patients with chronic hepatitis B showed that treatment with lamivudine for 1 year significantly improves liver histology and enhances hepatitis B e antigen (HBeAg) seroconversion compared with placebo. Fifty‐eight patients from this 1‐year study have received long‐term treatment with lamivudine 100 mg; the outcome of 3 years of lamivudine is reported here. Before treatment, all patients had detectable HBeAg. HBeAg seroconversion (HBeAg‐negative, anti‐HBe–positive), hepatitis B virus (HBV)‐DNA suppression, alanine transaminase (ALT) normalization, emergence of YMDD variant HBV, liver histology, and long‐term safety were assessed. After 3 years of continuous treatment with lamivudine 100 mg daily, 40% (23 of 58) of patients achieved HBeAg seroconversion. In patients with baseline serum ALT >2× upper limit of normal (ULN), the rate of HBeAg seroconversion was 65% (17 of 26). Median serum HBV‐DNA concentrations were below the level of detection, and median ALT concentrations were within the normal range throughout 3 years of treatment. YMDD variant HBV emerged in 33 of 58 (57%) patients during the 3 years, of whom 9 (27%) achieved HBeAg seroconversion (6 after emergence of YMDD variant HBV). ALT levels and histologic scores after emergence of YMDD variant HBV did not show major deterioration. Lamivudine was well tolerated during 3 years of therapy. In conclusion, these data in Chinese patients with chronic hepatitis B show enhanced seroconversion rates with extended lamivudine treatment. Up to two thirds of patients with moderately elevated pretreatment ALT achieved HBeAg seroconversion after 3 years of therapy.

Subfields: Epidemiology, Hepatology, Infectious Diseases

View Paper: https://www.semanticscholar.org/paper/e0fc4a09f99d8be5ddc3b38cb8babd0c42793ea8

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Ching‐lung Lai
N. Leung
J. Kao
T. Piratvisuth
E. Gane
M. Atkins
G. Lau
C. Hunt

Citations in the corpus

Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2008 update (2008, background): “The benefit of long-term therapy in preventing disease progression in patients with advanced fibrosis or cirrhosis also decreased after emergence of rtM204 I/V [71, 77].”
Prevalence and clinical correlates of YMDD variants during lamivudine therapy for patients with chronic hepatitis B. (2003, methodology): “Most patients in the Asian multicenter study B3009 [7] were enrolled into a follow-up study, study B3018 [23, 24], for up to 208 weeks; we included them to assess YMDD variants in patients undergoing extended lamivudine therapy.”