Beneficial effects of lamivudine in hepatitis B virus-related decompensated cirrhosis.

Abstract

BACKGROUND/AIMS:

HBV-related chronic liver disease patients often present with hepatic decompensation and are not eligible for interferon therapy. Whether long-term lamivudine is effective in these patients was prospectively evaluated.

METHODS:

Eighteen patients with HBV-related decompensated cirrhosis, all with quantitative DNA +ve and 10 HBeAg +ve, were given lamivudine 150 mg/d.

RESULTS:

Each patient received at least 9 months (mean 17.9) of lamivudine. Three HBeAg+ve patients (30%) seroconverted to anti-HBe and one lost HBsAg during the follow-up. An improvement from baseline in the aspartate aminotransferase (130 vs. 72 IU/l, p<0.04); alanine aminotransferase (111 vs. 58 IU/l, p<0.01) and Child-Pugh score (8.3 vs 6.7, p<0.013) was seen. Lamivudine had no significant side-effects. HBV DNA became undetectable in all patients by 8 weeks of therapy. In three (17%) patients, HBV DNA again became positive at 9, 9 and 27 months. YMDD mutant was, however, detected in only one (6%). A significant reduction was noted in the morbidity and hospitalizations for complications of liver disease before and after starting lamivudine (1.5+/-0.7 vs. 0.6+/-0.7, p<0.002).

CONCLUSIONS:

In decompensated HBV-related cirrhosis, lamivudine: i) is effective in suppressing HBV DNA and seroconversion to anti-HBe (30%), ii) can achieve significant improvement in clinical and biochemical status of liver functions.

• Authors: D Kapoor, R C Guptan, S M Wakil, S N Kazim, R Kaul, S R Agarwal, S Raisuddin, S E Hasnain, S K Sarin
• Journal: Journal of hepatology (J Hepatol) Vol. 33 Issue 2 Pg. 308-12 (Aug 2000) ISSN: 0168-8278 [Print] Netherlands
• PMID: 10952249 (Publication Type: Journal Article)

Chemical References

• Reverse Transcriptase Inhibitors
• Lamivudine

Topics

• Administration, Oral
• Adult
• Female
• Hepatitis B, Chronic (complications)
• Humans
• Lamivudine (administration & dosage)
• Liver Cirrhosis (drug therapy, etiology)
• Male
• Middle Aged
• Prospective Studies
• Reverse Transcriptase Inhibitors (administration & dosage)
• Time Factors
• Treatment Outcome