标题: Predictors early HBeAg loss during lamivudine therapy in eAg+ with acute exacerb [打印本页] 作者: StephenW 时间: 2011-1-6 22:28 标题: Predictors early HBeAg loss during lamivudine therapy in eAg+ with acute exacerb
Hepatology International
DOI: 10.1007/s12072-010-9227-xOnline First¢â
Original Article
Predictors for early HBeAg loss during lamivudine therapy in HBeAg-positive
chronic hepatitis B patients with acute exacerbation
Cheng-Yuan Peng, Chih-Bin Chen, Hsueh-Chou Lai, Wen-Pang Su, Po-Heng Chuang,
Hong-Dar Isaac Wu and Long-Bin Jeng
Abstract
Purpose
To examine the rate of early HBeAg loss and predictors of HBeAg loss in
HBeAg-positive chronic hepatitis B (CHB) patients with acute exacerbation (AE)
treated with lamivudine.
Methods
A total of 146 patients diagnosed with CHB and AEs were included in this
retrospective study. Patients were divided into two groups: decompensated and
compensated.
Results
The mean treatment duration for the decompensated and compensated groups was
18.1 and 19.9 months, respectively. Decompensated patients were significantly
older and had a higher prevalence of cirrhosis and genotype B infection than
compensated patients. Compared to compensated patients, decompensated patients
achieved a higher rate of HBeAg loss (25.8 vs. 14.3%; P = 0.0805) at 3 months of
therapy, a higher rate of serum HBV DNA negativity (53.2 vs. 29.8%; P = 0.0042),
and a lower rate of rtM204V/I mutation (3.2 vs. 16.7%; P = 0.0139) after 12
months of lamivudine therapy. The rates of HBeAg loss after 6 and 12 months of
lamivudine therapy were similar between the two groups. Logistic regression
analysis revealed that female gender and baseline ALT level ¡Ã1,000 IU/L, but
not decompensations, were significant predictors of HBeAg loss at 3 months;
however, only female gender was a significant predictor of HBeAg loss after 6
and 12 months of lamivudine therapy. The early HBeAg losers showed a
significantly higher sustained remission rate off lamivudine therapy.
Conclusions
Female gender and baseline serum ALT level ¡Ã1,000 IU/L were independent
predictors of early HBeAg loss during lamivudine therapy in HBeAg-positive CHB
patients with AE.