Correlations between fibrosis improvement after lamivudine treatment and pretreatment histological activity

Kang, Kyung Hee; Cho, Chang Min; Tak, Won Young; Kim, Sung Kook; Choi, Yong Hwan; Kweon, Young Oh

Abstract

BACKGROUND: Lamivudine has been found to suppress hepatitis B virus (HBV) consistently, and several trials have shown significant reductions in necroinflammatory activity and delayed progression of fibrosis. In terms of histologic improvements, fibosis is one of the most important factors in predicting long-term outcome in chronic hepatitis. The objective of this analysis was to determine the correlation between improvement in degree of fibrosis and pretreatment histological activity in lamivudine-treated patients with chronic hepatitis B.
METHODS
Paired liver biopsy in 47 patients who were treated with lamivudine and followed up for 52 weeks were analysed. Histological changes were evaluated by a histopathologist and scored according to Knodell's histology activity index (HAI).
RESULTS
At the end of one year, 33/47 (70.2%) showed improvement in necroinflammatory score and only 14.9% (7/47) showed worsening. The improvement in fibrosis score was noted in 21.3% (10/47). The improvement in fibrosis was significantly related with pretreatment periportal inflammation (p<0.05), portal inflammation (p<0.01) and fibrosis score (p<0.01). The loss of HBeAg occurred in 60% of fibrosis improvement group and interestingly, regression of fibrosis was noted in patients without loss of HBeAg.
CONCLUSIONS
Pretreatment histologic activity is an important predictor for improvement in fibrosis after lamivudine treatment for chronic hepatitis B.