Improved Child-Pugh Score after Lamivudine Treatment in Patients with Decompensated Cirrhosis Due to Hepatits B Virus Infection.
- Author:
Moon Seok CHOI
1
;
Seung Woon PAIK
;
Sang Jong PARK
;
Joon Hyeok LEE
;
Kwang Cheol KOH
;
Poong Lyul RHEE
;
Jae Jun KIM
;
Jong Chul RHEE
;
Kyoo Wan CHOI
Author Information
1. Division of Gastroenterology, Samsung Medical CenterSungkyunkwan University School of Medicine, Seoul, Korea. swpaik@samsung.co.kr
- Publication Type:Original Article
- Keywords:
HBV;
Cirrhosis;
Child-Pugh score;
Lamivudine
- MeSH:
DNA;
Fibrosis*;
Hepatitis B e Antigens;
Hepatitis B, Chronic;
Herpesvirus 1, Cercopithecine*;
Humans;
Incidence;
Lamivudine*;
Liver;
Liver Transplantation
- From:The Korean Journal of Hepatology
2000;6(4):481-487
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Lamivudine is an oral nucleoside analogue with potent antiviral activity against HBV inducing normalization of ALT and improvement of necro-inflammation and fibrosis in chronic hepatitis B. But its role in decompensated cirrhosis has not been established. The Child-Pugh score is a reliable and convenient prognostic indicator reflecting liver synthetic function. We evaluated the incidence of any improvement in Child-Pugh score after lamivudine treatment in patients with decompensated cirrhosis. METHODS: Twenty-six patients with HBV associated active decompensated cirrhosis showing detectable serum HBV received lamivudine (100 or 150 mg/day) for 6-45 months (median 16). The Child-Pugh score at 6th month of lamivudine treatment was compared with base line score. RESULTS: The Child-Pugh score improved ( 2-point reduction) in 17 (65.4%) patients, was constant in 8 (30.8%), and aggravated ( 2-point increase) in one (3.8%) of 26 patients. HBV DNA was initially cleared in 24 cases (92.3%) but breakthrough developed in 7 (29.2%). HBeAg was lost in 5 (25%) of 20 cases. Initial improvement was maintained in 14 (82.4%) of 17 cases but aggravated with breakthrough in 3 (17.6%). Two of 5 patients waiting for liver transplantation showed marked improvement and were removed from the list. CONCLUSION: Lamivudine can be an effective treatment for patients with decompensated cirrhosis due to HBV infection, improving the Child-Pugh score in many cases. However, deterioration of liver function associated with DNA breakthrough was an important problem in patients showing initial improvement.
