Efficacy of Lamivudine Re-treatment and Relapse Patterns after Initial Lamivudine Treatment for Chronic Hepatitis B Infection.
- Author:
Jong Ho PARK
1
;
Neung Hwa PARK
;
Jung Woo SHIN
;
Sung Jo BANG
;
Dae Hyun KIM
;
Kwang Ro JOO
;
Do Ha KIM
Author Information
1. Department of Internal Medicine, Ulsan University College of Medicine, Ulsan, Korea. nhpark@uuh.ulsan.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Hepatitis/Viral/Chronic viral hepatitis B;
Lamivudine;
Relapse;
Lamivudine re-treatment
- MeSH:
Adult;
Antiviral Agents/*therapeutic use;
Female;
Hepatitis B e Antigens/blood;
Hepatitis B, Chronic/diagnosis/*drug therapy/virology;
Humans;
Lamivudine/*therapeutic use;
Male;
Recurrence;
Retreatment
- From:The Korean Journal of Hepatology
2003;9(3):188-197
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The post-treatment relapse patterns and efficacy of lamivudine re-treatment for relapsed patients have not been clarified. The aims of this study were to evaluate the relapse patterns after discontinuing therapy and the effects of lamivudine re-treatment for relapsed patients after HBeAg seroconversion. METHODS: Therapy was discontinued after HBeAg seroconversion in 121 patients. Sixty-six patients were relapsed and included in this study. The duration of lamivudine re-treatment therapy was from 6-35 (mean: 16) months. Post-retreatment monitoring continued for 1-40 (mean: 8.9) months. RESULTS: Among the relapsed 66 patients, 50 (75.8%) had HBeAg reappearance while 16 (24.2%) remained HBeAg negative and anti-HBe positive. The cumulative relapse rates at 3, 6, 12 and 24 months were 27%, 47%, 60% and 66%, respectively. Forty-two relapsers received lamivudine re-treatment. Among them, 33 were HBeAg positive and 9 were HBeAg negative and anti-HBe positive, Response was achieved in 31 of the 42 patients (73.8%). The cumulative response rates at 6, 9 and 12 months were 62%, 69% and 72%, respectively. Six patients (14.3%) developed viral breakthrough. All patients were HBeAg positive chronic hepatitis B. The duration of lamivudine re-treatment was the only predictable factor for response of lamivudine re-treatment. Therapy was discontinued after response in 21 patients. Eleven patients were relapsed, including 6 who were HBeAg positive and 5 who were HBeAg negative. Predictive factors for post-retreatment relapse were age and the duration of additional lamivudine therapy after response. CONCLUSIONS: The response rate of lamivudine re-treatment was significantly higher than in initial lamivudine treatments. The breakthrough and relapse rates, however, were similar in both initial and retreated lamivudine therapy.
