Journal of Gastroenterology and Hepatology
Volume 20 Issue 3 Page 433 - March 2005
doi:10.1111/j.1440-1746.2005.03577.x
HEPATOLOGY
Factors associated with response to lamivudine: Retrospective study in a
tertiary care clinic serving patients with chronic hepatitis B
HIE-WON L HANN*, MICHELE L JONSSON FUNK, DANIEL M ROSENBERG AND RANDY DAVIS?BR>
Abstract
Background and Aims: Chronic hepatitis B (CHB) is an important cause of end
stage liver disease and hepatocellular carcinoma. Controlled clinical trials
indicate treatment with lamivudine results in positive clinical responses.
The study goal was to determine if the response to lamivudine treatment
(HBeAg loss, HBV DNA loss and alanine aminotransferase [ALT] reduction)
differs according to pretherapy (pre-tx) ALT levels.
Methods: This was a retrospective review of medical record data. All CHB
patients at all stages of disease (including cirrhotic) with more than two
visits to the clinic were included in the study (n = 719). Kaplan-Meier
survival and Cox proportional hazards were estimated.
Results: Of the total 719 HBsAg (+) patients, 317 were treated with
lamivudine 150 mg or 100 mg daily. Among HBeAg positive patients, at 3
years, Kaplan-Meier estimates of the loss of HBeAg were 40%, 57% and 61% for
pre-tx ALT < upper limit of normal (ULN), 12 ULN and >2 ULN, respectively.
Similar results of HBV-DNA loss were seen in HBeAg negative patients.
Conclusions: In this setting, we observed that pre-tx ALT levels were not
associated with response to lamivudine, but that lower platelet count and
female sex in HBeAg (+) patients were important predictive factors of a
favorable response to lamivudine therapy.
Accepted for publication 7 April 2004.
Affiliations
*Liver Disease Prevention Center Clinic, Division of Gastroenterology and
Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA,
University of North Carolina, Chapel Hill, NC, USA, GlaxoSmithKline (GSK),
Singapore and ?SK, Research Triangle Park, NC, USA
Correspondence
Dr Hie-Won L Hann, Jefferson Medical College, Liver Disease Prevention
Center, Division of Gastroenterology and Hepatology, Thomas Jefferson
University Hospital, 1025 Walnut Street, Room 910, Philadelphia, PA 19107,
USA. Email: [email protected]
To cite this article
HANN, HIE-WON L, JONSSON FUNK, MICHELE L, ROSENBERG, DANIEL M & DAVIS, RANDY
(2005)
Factors associated with response to lamivudine: Retrospective study in a
tertiary care clinic serving patients with chronic hepatitis B.
Journal of Gastroenterology and Hepatology 20 (3), 433-440.
doi: 10.1111/
j.1440-1746.2005.03577.x
| 
发表于 2005-3-22 04:05
