Sustained response after a 2-year course of ...

liver411

Journal of Viral Hepatitis
Volume 11 Issue 5 Page 432  - September 2004
doi:10.1111/j.1365-2893.2004.00556.x

[B]Sustained response after a 2-year course of lamivudine treatment of
hepatitis B e antigen-negative chronic hepatitis B[/B]
S. K. Fung1,2, F. Wong1, M. Hussain2 and A. S. F. Lok2

Summary. Lamivudine has demonstrated efficacy for the treatment of hepatitis
B e antigen-negative chronic hepatitis B (e-CHB). However, treatment
withdrawal after 1 year has been associated with a high rate of relapse
while long-term treatment is associated with increasing risks of drug
resistance. We report our treatment experience of 50 Chinese-Canadian
patients with e-CHB. All patients received lamivudine for 2 years. Treatment
was withdrawn at month 24 in patients who had undetectable hepatitis B virus
(HBV) DNA by PCR and normal aminotransferases during the second year of
therapy. All patients had HBV genotype B or C. Biochemical response at
months 6, 12 and 24 was 74%, 71% and 66%, respectively. HBV DNA was
undetectable at months 6, 12 and 24 by hybrid capture and PCR assays in
100%, 92% and 86%; and 94%, 88% and 74% patients, respectively. The
cumulative rates of genotypic resistance (GR) after 1 and 2 years were 15%
and 25%, respectively. Four (44%) patients with GR experienced a hepatitis
flare. The probability of clinical and virological relapse 6, 12, and 18
months after treatment withdrawal were 12% and 30%, 18% and 50%, and 30% and
50%, respectively. Reinstitution of lamivudine resulted in prompt
virological and biochemical responses. Our study demonstrates that a
sustained response can be achieved after a 2-year course of lamivudine in a
subset of patients with e-CHB.