Long-term lamivudine treatment for chronic hepatitis B in Japanese patients: a project of Kyushu University Liver Disease Study.

Abstract

AIM:

To determine the efficacy of long-term lamivudine treatment of a large number of Japanese patients with chronic hepatitis B.

METHODS:

In this retrospective, multi-center trial, 318 Japanese patients with chronic hepatitis B received 100 mg of lamivudine daily for up to 36 (median 21) mo. Virological response was a decline to a serum HBV DNA level less than 3.7 log copies/mL. Virological breakthrough was defined as the reappearance of a serum HBV DNA level to more than 10-fold the minimum during treatment.

RESULTS:

Lamivudine produced virological response in 86.8% of the 318 patients at 6 mo, in 80.2% of 252 patients at 12 mo, in 69.2% of 133 patients at 24 mo, and in 53.6% of 28 patients at 36 mo. Forward stepwise logistic regression analysis showed an HBV DNA level less than 6.8 log copies/mL (P<0.0001), HBeAg negativity (P<0.0001), a platelet count of 100 x 10(9)/L or more (P=0.0162) at baseline, and a decline of the HBV DNA level of more than 3.2 log copies/mL as compared with the baseline level at 3 mo after the start of treatment (P=0.0003) to be significantly associated with virological response. Among patients with a virological response, virological breakthrough was seen in 5.3% of 19 patients who responded virologically at 1 mo, in 20.7% of 203 patients at 3 mo, in 27.5% of 51 patients at 6 mo, in 33.3% of 12 patients at 9 mo, and in 100% of 3 patients at >=5 mo. A virological breakthrough was found significantly more often in patients with delayed virological response.

CONCLUSION:

Lamivudine treatment could suppress serum HBV DNA in most of the tested Japanese patients. Long-term efficacy might be seen in patients without HBeAg at baseline, in the absence of cirrhosis, and in patients with a decline in HBV DNA level soon after the start of treatment.

• Authors: Norihiro Furusyo, Hiroaki Takeoka, Kazuhiro Toyoda, Masayuki Murata, Yuichi Tanabe, Eiji Kajiwara, Junya Shimono, Akihide Masumoto, Toshihiro Maruyama, Hideyuki Nomura, Makoto Nakamuta, Kazuhiro Takahashi, Shinji Shimoda, Koichi Azuma, Hironori Sakai, Jun Hayashi
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 12 Issue 4 Pg. 561-7 (Jan 28 2006) ISSN: 1007-9327 [Print] United States
• PMID: 16489669 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents
• DNA, Viral
• Hepatitis B e Antigens
• Lamivudine
• Alanine Transaminase

Topics

• Adult
• Aged
• Alanine Transaminase (blood)
• Antiviral Agents (therapeutic use)
• DNA, Viral (blood)
• Female
• Genotype
• Hepatitis B e Antigens (blood)
• Hepatitis B virus (classification, genetics)
• Hepatitis B, Chronic (drug therapy, virology)
• Humans
• Lamivudine (therapeutic use)
• Male
• Middle Aged
• Retrospective Studies