Most HBeAg-negative Patients in a Chinese

OCD

[B]Most HBeAg-negative Patients in a Chinese Cohort Experience Relapse Within 12 Months After Epivir-HBV (lamivudine) Treatment Regardless of HBV Genotype [/B]

The efficacy of lamivudine for HBeAg-negative chronic hepatitis B (CHB) Chinese patients has not been fully investigated. The role of the Hepatitis B virus (HBV) genotype on the treatment effect of lamivudine is controversial.

Thirty-two consecutive patients with HBeAg-negative CHB were enrolled. All patients were treated with lamivudine 100 mg once daily for 7-12 months. The mean total period of follow-up since entry for all patients was 24 ± 3.5 months.

HBV genotypes were classified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and verified by sequencing.

Twenty-one (65.6%) patients were infected by genotype B and, 11 (34.4%) by genotype C. G1896A was predominant in genotype B infected patients (95.2%vs 63.6%, P = 0.037).

At the end of treatment, 31 (96.8%) and 14 (43.8%) patients achieved biochemical and virological responses, respectively. The biochemical and virological response rates were 40.6 and 0% at 12 months after treatment.

Eighteen (56.3%) patients had biochemical relapse within 12 months after withdrawal of lamivudine.

By multivariate analysis, the pretreatment serum level of HBV DNA  12 Meq/mL was the only factor associated with early biochemical relapse.

The authors conclude, “The virological effect of lamivudine for HBeAg-negative CHB is transient. Most patients had biochemical relapse within 12 months after lamivudine treatment regardless of HBV genotype. A high pretreatment viral load is the determinant for early biochemical relapse.”

08/06/03

Reference
Y-H Huang and others. Analysis of clinical, biochemical and viral factors associated with early relapse after lamivudine treatment for hepatitis B e antigen-negative chronic hepatitis B patients in Taiwan. Journal of Viral Hepatitis 10(4): 277-284. July 2003.