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

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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 Jan 1

Fingerprint

Lamivudine
Chronic Hepatitis B
Hepatitis B virus
DNA
Hepatitis B e Antigens
Serum
Alanine Transaminase
Therapeutics
Branched DNA Signal Amplification Assay
Incidence
Viral DNA

Keywords

  • Chronic hepatitis B
  • Hepatitis B virus DNA
  • Lamivudine

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

@article{3d0e3a6399c14cbd9fee529109070b37,
title = "Clinical outcomes of chronic hepatitis B patients with persistently detectable serum hepatitis B virus DNA during lamivudine therapy",
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.",
keywords = "Chronic hepatitis B, Hepatitis B virus DNA, Lamivudine",
author = "Kim, {Ji Hoon} and Yu, {Sang K.} and Seo, {Yeon Seok} and Yim, {Hyung Joon} and Yeon, {Jong Eun} and Park, {Jong Jae} and Kim, {Jae Seon} and Young-Tae Bak and Lee, {Chang H.} and Byun, {Kwan Soo}",
year = "2007",
month = "1",
day = "1",
doi = "10.1111/j.1440-1746.2007.04921.x",
language = "English",
volume = "22",
pages = "1220--1225",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
number = "8",

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TY - JOUR

T1 - Clinical outcomes of chronic hepatitis B patients with persistently detectable serum hepatitis B virus DNA during lamivudine therapy

AU - Kim, Ji Hoon

AU - Yu, Sang K.

AU - Seo, Yeon Seok

AU - Yim, Hyung Joon

AU - Yeon, Jong Eun

AU - Park, Jong Jae

AU - Kim, Jae Seon

AU - Bak, Young-Tae

AU - Lee, Chang H.

AU - Byun, Kwan Soo

PY - 2007/1/1

Y1 - 2007/1/1

N2 - 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.

AB - 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.

KW - Chronic hepatitis B

KW - Hepatitis B virus DNA

KW - Lamivudine

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U2 - 10.1111/j.1440-1746.2007.04921.x

DO - 10.1111/j.1440-1746.2007.04921.x

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JO - Journal of Gastroenterology and Hepatology (Australia)

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