Predictive factors associated with the progression to hepatic failure caused by lamivudine-resistant HBV.

Abstract	The aims of this study were to select the patients with a potential for progression to hepatic failure due to lamivudine-resistant HBV and to standardize the treatment for patients with lamivudine-resistant HBV. Patients (n = 47) with reactivated hepatitis due to lamivudine-resistant HBV were classified into two groups, with and without potential for progression to hepatic failure, according to the criteria using the data of serum bilirubin level and prothrombin activity after the reactivated hepatitis. Multivariate analysis showed that prothrombin activity at the initiation of lamivudine therapy was related to the deterioration of the liver function after the emergence of lamivudine-resistant HBV (P = 0.0025, 95%CI 0.8269-0.9601). We assume that earlier additional or substitutive treatment with other antiviral agent, such as adefovir dipivoxil, should be recommended when the lamivudine-resistant HBV is detected in patients with the history of decompensated liver disease before the administration of lamivudine, even when hepatitis has not been reactivated yet.
Authors	Reiichiro Kuwahara, Ryukichi Kumashiro, Tatsuya Ide, Yuriko Koga, Teruko Hino, Akiko Hisamochi, Kazuo Tanaka, Kei Ogata, Hiroyuki Koga, Yukari Takao, Michio Sata
Journal	Digestive diseases and sciences (Dig Dis Sci) Vol. 53 Issue 11 Pg. 2999-3006 (Nov 2008) ISSN: 0163-2116 [Print] United States
PMID	18618250 (Publication Type: Journal Article)
Chemical References	Antiviral Agents Organophosphonates Lamivudine Adenine Bilirubin adefovir dipivoxil
Topics	Adenine (analogs & derivatives, pharmacology, therapeutic use) Adult Antiviral Agents (pharmacology, therapeutic use) Bilirubin (blood) Disease Progression Drug Resistance, Viral Female Follow-Up Studies Hepatitis B (blood, complications, drug therapy) Hepatitis B virus (drug effects) Humans Lamivudine (pharmacology, therapeutic use) Liver Failure (blood, etiology) Male Middle Aged Multivariate Analysis Organophosphonates (pharmacology, therapeutic use) Patient Selection Predictive Value of Tests Prognosis Prothrombin Time Retrospective Studies Treatment Outcome

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