Viral breakthrough in HBeAg-negative chronic hepatitis B patients receiving lamivudine therapy

Yun Jung Chang, Jeong Yoon Yim, Nam Young Cho, Chang Won Choi, Soo Jung Baek, Soo Hyun Ahn, Do Won Choi, Yong Dae Kwon, Sun Suk Kim, Oh Sang Kwon, Ju Hyun Kim, Jong Eun Yeon, Jin Won Song, Kwan Soo Byun, Chang Hong Lee

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3 Citations (Scopus)

Abstract

BACKGROUND/AIMS: Long-term efficacy and the rate of viral breakthrough in patients with HBeAg- negative chronic hepatitis B receiving lamivudine therapy is uncertain. This study was conducted to determine the rate of viral breakthrough according to the HBeAg status and the relation of viral breakthrough with YMDD mutants. METHODS: Two hundred and five patients with HBeAg-positive and 49 patients with HBeAg-negative chronic hepatitis B, who had received lamivudine for at least 9 months, were included. The mean durations of the lamivudine treatment were 176 months and 155 months in HBeAg-positive and negative patients, respectively. Analysis of HBV genome for YMDD mutations was performed by restriction-fragment-length polymorphism assay and direct sequencing. RESULTS: While the cumulative rates of viral breakthrough at 12th and 24th months of the lamivudine therapy were 0% and 7% in the HBeAg-negative group, they were 12% and 39% in the HBeAg-positive group. The cumulative rate of viral breakthrough in the HBeAg-negative group was significantly lower than in the HBeAg-positive group (p<0.01). In multivariate analysis, the only significant factor related to viral breakthrough was the HBeAg status (p<0.05). The YMDD mutants were detected in all patients with viral breakthrough irrespective of HBeAg status. However, in patients without viral breakthrough, the rate of YMDD mutants was significantly higher in the HBeAg-negative group than in the HBeAg-positive group (13.3% vs 5.1%; p<0.01). CONCLUSIONS: Lamivudine is expected to be more persistently effective in HBeAg-negative chronic hepatitis B because of a lower viral breakthrough rate than in HBeAg-positive chronic hepatitis B in spite of the emergence of YMDD mutants.

Original languageEnglish
Pages (from-to)397-404
Number of pages8
JournalTaehan Kan Hakhoe chi = The Korean journal of hepatology
Volume8
Issue number4
Publication statusPublished - 2002 Dec

ASJC Scopus subject areas

  • Medicine(all)

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    Chang, Y. J., Yim, J. Y., Cho, N. Y., Choi, C. W., Baek, S. J., Ahn, S. H., Choi, D. W., Kwon, Y. D., Kim, S. S., Kwon, O. S., Kim, J. H., Yeon, J. E., Song, J. W., Byun, K. S., & Lee, C. H. (2002). Viral breakthrough in HBeAg-negative chronic hepatitis B patients receiving lamivudine therapy. Taehan Kan Hakhoe chi = The Korean journal of hepatology, 8(4), 397-404.