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发表于 2004-5-2 00:56
Among Children Who Were Nonresponders to Interferon, One Year Treatment with Lamivudine Provided Benefits
Data regarding the effect of extended lamivudine (Epivir-HBV) treatment in children who failed to respond to previous IFN alfa therapy are scarce. Therefore, the effects of lamivudine treatment on ALT activity, HBV DNA and HBeAg seroconversion as well as the occurence of YMDD mutant and adverse effects were determined.
The observation was carried out on 52 children, aged 4-17 years, with biopsy-proven chronic hepatitis B (HBeAg+, HBV DNA+, wild-type virus+), who were nonresponders to previous IFN alfa therapy in the dose of 3MU 3 times weekly for 20 weeks. Lamivudine at the dose of 3-4mg/kg/day up to 100mg/day was given for 24 months.
Results
51 children completed 12 months and 25 of them ?24 months of therapy; one boy was excluded from this study due to severe thrombocytopenia. After a year of lamivudine therapy 31.3% of children cleared HBV DNA, 78.3% normalized ALT activity and 7.8% lost HBeAg.
After completion of 24-month therapy 52% of children cleared HBV DNA, 28% seroconverted to antiHBe and 66.6% normalized ALT activity.
No adverse effects were noted, except thrombocytopenia.
YMDD mutant was present in 20% of children after one year of therapy, in 32% - 6 months later and in 52% after two years of treatment.
The authors conclude, 揟he 24-month treatment with lamivudine in children with chronic hepatitis B who did not respond to IFN alfa normalized ALT activity in most children and caused seroconversion to antiHBe in 28%. However it was associated with a high risk for developing YMDD mutation.?/span>
04/30/04
Reference
D M Lebensztejn and others. A PROSPECTIVE OPEN STUDY OF LONG-TERM LAMIVUDINE TREATMENT IN CHILDREN WITH CHRONIC HEPATITIS B UNRESPONSIVE TO PREVIOUS INTERFERON ALPHA THERAPY.?Abstract 433. 39th EASL. April 14-18, 2004. Berlin, Germany.
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