Long-term Efficacy and Durability of Lamivudine Therapy in Patients with Chronic Hepatitis B

Hong, Sung Pil; Han, Kwang Hyub; Ahn, Sang Hoon; Paik, Yong Han; Moon, Byung Soo; Chon, Chae Yoon; Moon, Young Myoung

Abstract

BACKGROUND/AIMS: It has been reported in patients with chronic hepatitis B, that the response rate of lamivudine therapy increases in proportion to the duration of the therapy. What was not well known was the durability of the therapeutic response after the cessation of lamivudine therapy. The aim of this study was to evaluate the long-term efficacy and durability of lamivudine therapy in patients with chronic hepatitis B. Patients and
METHODS
We retrospectively analyzed 73 patients with chronic hepatitis B who were treated with lamivudine 100 mg orally once daily and followed up for more than 12 months between April 1997 and March 1999. Sixty-three patients were initially hepatitis B e antigen (HBeAg) positive and Hepatitis B virus (HBV) DNA positive (group I). Ten patients were HBeAg negative and HBV DNA positive (group II). The responders were those who had negative conversion of HBV DNA and normalization of alanine aminotransferase (ALT). Treatment was stopped after HBeAg seroconversion in group I and after thaerapeutic response in group II.
RESULTS
The response rates of group I and group II were 68.3% and 70.0% at 12 months, respectively (P = NS). In group I, cumulative HBeAg seroconversion rates at 1 year, 2 years, and 3 years were 30.2%, 38.8%, and 42.4%, respectively. The cumulative durability of response was higher in group I than in group II (64.6% vs. 33.3% at 1 year; 35.4% vs. 22.2% at 2 years; P = .079). The cumulative durability of response was significantly higher in patients who received additional lamivudine therapy for more than 6 months after HBeAg seroconversion than for less than 6 months (90.0% vs. 40.0% at 1 year; 90.0% vs. 20.0% at 2 years; P = .013).
CONCLUSIONS
The long-term response to lamivudine therapy showed no difference between HBeAg-negative/HBV DNA-positive and HBeAg-positive patients. The HBeAg seroconversion rate increased in proportion to the duration of lamivudine therapy. The Continuation of treatment for more than 6 months after HBeAg seroconversion might increase the durability of response.