Journal of Viral Hepatitis
OnlineEarly
doi:10.1111/j.1365-2893.2005.00606.x
Efficacy of lamivudine re-treatment for relapsed patients after an initial
lamivudine therapy in HBeAg-positive chronic hepatitis B
J. W. Shin, N. H. Park, J. H. Park, J. H. Park, I. D. Jeong, S-J. Bang, K.
R. Joo and D. H. Kim
Summary. The efficacy of lamivudine re-treatment in chronic hepatitis B
(CHB) patients who relapse after HBeAg seroconversion with lamivudine has
not been investigated. The aim of this study was to evaluate the efficacy of
lamivudine re-treatment in relapsed patients. Among 192 patients who had
achieved HBeAg seroconversion with lamivudine at a dose of 100 mg/day, 121
patients discontinued lamivudine. Relapse occurred in 49 patients (40.5%).
Thirty-three relapsed patients received lamivudine re-treatment for at least
6 months. The mean duration of lamivudine re-treatment was 16 months and the
follow-up period was 8.9 months. HBeAg seroconversion was achieved in 23
patients (69.7%). The cumulative HBeAg seroconversion rates at 5, 9, and 12
months were 60, 64, and 67%, respectively. The mean time to HBeAg
seroconversion in lamivudine re-treatment was shorter than that in the
initial therapy (4.7 months vs. 9.7 months). Viral breakthrough occurred in
six (18.2%) patients. All patients with viral breakthrough were accompanied
by elevation of serum alanine aminotransferase (ALT) levels. Among 15
patients who discontinued lamivudine re-treatment after HBeAg
seroconversion, relapse occurred in six patients (40%). All relapses
occurred within 9 months after the discontinuation of lamivudine
re-treatment. In conclusion, lamivudine re-treatment in relapsed patients
after initial lamivudine therapy had a higher response rate and shorter
duration to HBeAg seroconversion than during the initial therapy. However,
HBeAg seroconversion induced by lamivudine re-treatment was not durable.
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