Clinical outcomes of chronic hepatitis B patients with persistently detectable serum hepatitis B virus DNA during lamivudine therapy

Ji H. Kim, Sang K. Yu, Yeon S. Seo, Hyung J. Yim, Jong E. Yeon, Jong J. Park, Jae S. Kim, Young T. Bak, Chang H. Lee, Kwan S. Byun

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Aim: A small proportion of chronic hepatitis B patients have persistently detectable serum hepatitis B virus (HBV) DNA despite lamivudine therapy. The incidence and clinical outcomes of patients who persistently have detectable serum HBV-DNA during lamivudine therapy was investigated. Method: We enrolled 221 chronic hepatitis B patients who underwent lamivudine therapy for more than 6 months. Among them, 180 were HBeAg positive. Serum HBV-DNA, HBeAg, anti-HBe and alanine aminotransferase (ALT) levels were serially monitored. The study groups were defined, using a hybridization assay, as patients with reductions in serum HBV-DNA below the detectable level (group I) or patients with persistently detectable serum HBV-DNA (group II) during the initial 6 months of lamivudine therapy. Results: The incidence of patients who had persistently detectable HBV-DNA was 7.7%. After the first year, the rates of viral breakthrough, HBeAg loss and serum ALT normalization of group I versus group II were 21% versus 63%, 38% versus 0%, and 71% versus 28%, respectively (P < 0.001). The log10 reduction of serum HBV-DNA at 6 months was -4.58 log10 for group I and -1.97 log10 for group II (P < 0.001, bDNA assay). There were no pretreatment lamivudine-resistant mutants in group II. Conclusion: Lamivudine had little effect on serum HBV-DNA suppression, viral breakthrough suppression and rate of HBeAg loss and ALT normalization in chronic hepatitis B patients with persistently detectable serum HBV-DNA during the initial 6 months of therapy. Early termination of lamivudine therapy is advocated for these patients.

Original languageEnglish
Pages (from-to)1220-1225
Number of pages6
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume22
Issue number8
DOIs
Publication statusPublished - 2007 Aug

Keywords

  • Chronic hepatitis B
  • Hepatitis B virus DNA
  • Lamivudine

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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