Hee Bok Chae1, Hie-Won Hann. 1. Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of Medicine, Jefferson Medical College and Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Abstract
AIM: To identify the factors associated with virologic breakthrough and to select a subgroup of patients who respond well to lamivudine without developing virologic breakthrough (VBT). METHODS: Of 79 patients who had received lamivudine therapy for 9-57 mo, 34 were HBeAg-positive and 45 were HBeAg-negative, 24 developed virologic breakthrough and 55 did not. Clinical and virologic factors were compared between the two groups. RESULTS: The median duration of therapy was 25 (9-57) mo. Virologic breakthrough was defined as a > 1 log HBV DNA increase following initial suppression. When several factors, including gender, duration of infection, baseline HBV DNA, and baseline ALT in HBeAg-positive chronic hepatitis patients were analyzed by logistic regression, the most important predictor of virologic breakthrough was the baseline HBV DNA (r2 = 0.12, P < 0.05). When HBeAg-positive chronic hepatitis patients were divided into two groups by a point of 6.6 log HBV DNA, the incidence of virologic breakthough between two groups was significantly different. CONCLUSION: Lamivudine may remain an effective first line therapy for those HBeAg-positive patients with a baseline HBV DNA < 6.6 log10 copies/mL.
AIM: To identify the factors associated with virologic breakthrough and to select a subgroup of patients who respond well to lamivudine without developing virologic breakthrough (VBT). METHODS: Of 79 patients who had received lamivudine therapy for 9-57 mo, 34 were HBeAg-positive and 45 were HBeAg-negative, 24 developed virologic breakthrough and 55 did not. Clinical and virologic factors were compared between the two groups. RESULTS: The median duration of therapy was 25 (9-57) mo. Virologic breakthrough was defined as a > 1 log HBV DNA increase following initial suppression. When several factors, including gender, duration of infection, baseline HBV DNA, and baseline ALT in HBeAg-positive chronic hepatitispatients were analyzed by logistic regression, the most important predictor of virologic breakthrough was the baseline HBV DNA (r2 = 0.12, P < 0.05). When HBeAg-positive chronic hepatitispatients were divided into two groups by a point of 6.6 log HBV DNA, the incidence of virologic breakthough between two groups was significantly different. CONCLUSION:Lamivudine may remain an effective first line therapy for those HBeAg-positive patients with a baseline HBV DNA < 6.6 log10 copies/mL.
Authors: J P Villeneuve; L D Condreay; B Willems; G Pomier-Layrargues; D Fenyves; M Bilodeau; R Leduc; K Peltekian; F Wong; M Margulies; E J Heathcote Journal: Hepatology Date: 2000-01 Impact factor: 17.425
Authors: Fasiha Kanwal; Ian M Gralnek; Ron D Hays; Gareth S Dulai; Brennan M R Spiegel; Samuel Bozzette; Steve Asch Journal: Am J Gastroenterol Date: 2005-09 Impact factor: 10.864
Authors: Yun-Fan Liaw; Joseph J Y Sung; Wan Cheng Chow; Geoffrey Farrell; Cha-Ze Lee; Hon Yuen; Tawesak Tanwandee; Qi-Min Tao; Kelly Shue; Oliver N Keene; Jonathan S Dixon; D Fraser Gray; Jan Sabbat Journal: N Engl J Med Date: 2004-10-07 Impact factor: 91.245
Authors: Hie-Won L Hann; Robert J Fontana; Teresa Wright; Gregory Everson; Alfred Baker; Eugene R Schiff; Carolyn Riely; Gaya Anschuetz; Stephen D Gardner; Nathaniel Brown; Dorothea Griffiths Journal: Liver Transpl Date: 2003-01 Impact factor: 5.799
Authors: Emmet B Keeffe; Douglas T Dieterich; Steve-Huy B Han; Ira M Jacobson; Paul Martin; Eugene R Schiff; Hillel Tobias; Teresa L Wright Journal: Clin Gastroenterol Hepatol Date: 2004-02 Impact factor: 11.382