拉米能有效的降低E抗原阴性的HBV的病毒载量

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Lamivudine Effectively Reduces HBV Viral Load in HBeAg-negative Patients


The effect of lamivudine (Epivir-HBV) treatment on the outcome of patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis is unclear.

In a retrospective multicenter study, researchers have analyzed the virological events observed during lamivudine therapy in patients with HBeAg-negative chronic hepatitis and evaluated the correlation between virological response and clinical outcomes.

Among 656 patients (mean age 49.1 years) included in the database, 54% had chronic hepatitis, 30% had Child-Turcotte-Pugh (CTP) A cirrhosis, and 16% had CTP B/C cirrhosis.

On therapy (median 22 months, range 1-66), a virological response was obtained in 616 patients (93.9%). The rate of maintained virological response was 39% after 4 years.

During follow-up, 47 (7.2%) patients underwent liver transplantation, liver disease worsened in 31 (4.7%), hepatocellular carcinoma (HCC) developed in 31 (4.7%), and 24 patients (3.6%) died of liver-related causes.

Patients who had cirrhosis and who maintained virological response were less likely than those with viral breakthrough to develop HCC (P < .001) and disease worsening (P < .001).

Survival was better in CTP A patients with cirrhosis and maintained virological response (P = .01 by rank test).

Multivariate analysis revealed that presence of cirrhosis and viral breakthrough were independently related to mortality and development of HCC.

The authors conclude, 搮Lamivudine is highly effective in reducing [HBV] viral load in HBeAg-negative patients. After 4 years of therapy, 39% of patients maintain a virological and biochemical response.?

揕oss of virological response may lead to clinical deterioration in patients with cirrhosis.?/span>

09/29/04
Reference
V Di Marco and others (for the Italian Association for the Study of the Liver. Lamivudine Study Group, Italy). Clinical outcome of HBeAg-negative chronic hepatitis B in relation to virological response to lamivudine. Hepatology 40(4): 883-891. October 2004.
Summary Article on lamivudine