PURPOSE: There are remarkable advances in the treatment of chronic hepatitis B (CHB) in the last few years. Unfortunately, prolonged antiviral treatment is associated with increasing risk of drug resistance/viral breakthrough (VBT), which may lead to flare-up and rapid decompensation. We have designed this study to predict the pretreatment and on-treatment factors responsible for development of VBT. METHODS: This study was conducted during the period of February 2000 to November 2007. We have included 423 patients who received lamivudine (LAM) therapy for at least 1 year and at least 2 follow-ups at 6 months' interval. Follow-up period was 12-78 months. Chi-square test, student's t test, and logistic regression analysis were performed to prove the validity. RESULTS: Of the 423 study cases, 367 (86.8%) were of male patients and 261 (61.7%) patients were HBeAg positive; the age of the patients was 30.8 +/- 12.9 years. Development of VBT was 4.4, 22.8, 45.3, and 74% at 1, 2, 3, and 4 or more years, respectively. Pretreatment high HBV DNA (P = 0.005) and female sex (P = 0.01) were associated with VBT and pretherapy ALT (P = 0.698), HBeAg status (P = 0.273), and age (P = 0.059) were not associated. Duration of treatment, failure to lose HBeAg at 1 year, and HBV DNA nonresponder at 6 months were significantly (P = 0.001) associated with development of VBT. CONCLUSION: Persistence of HBeAg at 1 year and HBV DNA nonresponder at 6 months are good predictors of development of VBT.
PURPOSE: There are remarkable advances in the treatment of chronic hepatitis B (CHB) in the last few years. Unfortunately, prolonged antiviral treatment is associated with increasing risk of drug resistance/viral breakthrough (VBT), which may lead to flare-up and rapid decompensation. We have designed this study to predict the pretreatment and on-treatment factors responsible for development of VBT. METHODS: This study was conducted during the period of February 2000 to November 2007. We have included 423 patients who received lamivudine (LAM) therapy for at least 1 year and at least 2 follow-ups at 6 months' interval. Follow-up period was 12-78 months. Chi-square test, student's t test, and logistic regression analysis were performed to prove the validity. RESULTS: Of the 423 study cases, 367 (86.8%) were of male patients and 261 (61.7%) patients were HBeAg positive; the age of the patients was 30.8 +/- 12.9 years. Development of VBT was 4.4, 22.8, 45.3, and 74% at 1, 2, 3, and 4 or more years, respectively. Pretreatment high HBV DNA (P = 0.005) and female sex (P = 0.01) were associated with VBT and pretherapy ALT (P = 0.698), HBeAg status (P = 0.273), and age (P = 0.059) were not associated. Duration of treatment, failure to lose HBeAg at 1 year, and HBV DNA nonresponder at 6 months were significantly (P = 0.001) associated with development of VBT. CONCLUSION: Persistence of HBeAg at 1 year and HBV DNA nonresponder at 6 months are good predictors of development of VBT.
Authors: N W Leung; C L Lai; T T Chang; R Guan; C M Lee; K Y Ng; S G Lim; P C Wu; J C Dent; S Edmundson; L D Condreay; R N Chien Journal: Hepatology Date: 2001-06 Impact factor: 17.425
Authors: Y F Liaw; N W Leung; T T Chang; R Guan; D I Tai; K Y Ng; R N Chien; J Dent; L Roman; S Edmundson; C L Lai Journal: Gastroenterology Date: 2000-07 Impact factor: 22.682
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: Alexander J V Thompson; Anna Ayres; Lilly Yuen; Angeline Bartholomeusz; D Scott Bowden; David M Iser; Robert Y M Chen; Barbara Demediuk; Gideon Shaw; Sally J Bell; Katrina J R Watson; Stephen A Locarnini; Paul V Desmond Journal: J Gastroenterol Hepatol Date: 2007-07 Impact factor: 4.029