Lamivudine monotherapy in children with immune-tolerant chronic hepatitis B virus.

We investigated the efficacy of lamivudine treatment in inducing a primary and sustained response in naive pediatric patients with immune-tolerant chronic hepatitis B viral (HBV) infection. Lamivudine was used (maximum 100 mg/day) for an average of 35 months (16-60 months) for 17 patients, while 6 patients were untreated. All the treated patients became HBV-DNA negative in the twelfth month of therapy with an average of 7 months, however none of them had a sustained virological response. They all became HBV-DNA positive by the twentieth month on average. One patient had significant improvement in liver histology. No side effects were observed. Spontaneous HBV-DNA clearance or HBe seroconversion was obtained in none of the untreated cases. This study suggests that lamivudine cannot induce complete viral control in HBV pediatric immune-tolerant patients.