Lamivudine therapy for chronic hepatitis B: efficacy, predictive factors for response and relapse rate after treatment

Song, Byung Choel; Suh, Dong Jin; Lee, Han Chu; Chung, Young Hwa; Lee, Yung Sang

Abstract

BACKGROUND
It has been suggested that clearance of HBeAg was usually durable in Caucasians with chronic hepatitis B (CHB) after cessation of lamivudine, but little is known whether such effect is durable in Asian patients. The aim of this study was to evaluate the therapeutic efficacy of lamivudine, the predictive factors for response (defined as clearance of both HBV-DNA and HBeAg) and relapse rate in patients with CHB.
METHODS
We retrospectively analyzed 67 patients with CHB who were treated with lamivudine from August 1996 to September 1997. Among them, 41 were non-responders to interferon alpha. Lamivudine was given at a dose of 150 mg a day over 6 months. In responders, lamivudine was continued between 2 and 4 months more after clearance of HBeAg and they were followed for 12 months without further treatment. Mean duration of therapy in responders and non-responders was 8.9 months (range; 6-13 months) and 11.6 months (range; 7-22 months) respectively.
RESULTS
51 (79.1%) cleared serum HBV-DNA, 31 (46.3%) cleared both serum HBV-DNA and HBeAg, and 25 patients (37.3%) were seroconverted to anti-HBe. Predictive factors for response were female, high levels of serum ALT and low levels of serum HBV-DNA. However, during follow-up in responders, the cumulative relapse rate was 64% at 12 months.
CONCLUSION
Although lamivudine effectively suppressed HBV replication, relapse rate was high even in responders. It is suggested that the response to lamivudine is not durable in Korean patients with CHB.