AUGUST 2005
HBeAg-negative CHRONIC HEPATITIS B
Long-term lamivudine therapy. George Papatheodoridis and colleagues reviewed the clinical outcomes of 201 patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B who had received long-term therapy with the nucleoside analog lamivudine. The results were compared with those of 2 historical cohorts: the first cohort (n = 209) was treated with interferon-alpha and the second cohort (n = 195) was untreated. Virologic and biochemical responses at 48 months of lamivudine therapy occurred in 34% and 36% of patients, respectively. The 5-year overall and event-free survival rates were 96% and 93%, respectively, and were independently associated with response to treatment. Furthermore, overall and event-free survival were improved significantly in patients who were treated with long-term lamivudine therapy or were sustained responders to interferon compared with patients who were untreated or were not sustained responders to interferon. These data show that long-term nucleoside analog therapy improves survival and reduces the incidence of major complications in patients with HBeAg-negative chronic hepatitis B. However, the benefit is observed mostly among patients without lamivudine resistance. (Papatheodoridis G, et al. Hepatology. 2005;42:121–129) |