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The 13 C‐caffeine breath test distinguishes significant fibrosis in chronic hepatitis B and reflects response to lamivudine therapy
Author(s) -
PARK G. J.H.,
KATELARIS P. H.,
JONES D. B.,
SEOW F.,
LIN B. P. C.,
LE COUTEUR D. G.,
NGU M. C.
Publication year - 2005
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2005.02623.x
Subject(s) - caffeine , lamivudine , medicine , gastroenterology , breath test , fibrosis , chronic hepatitis , liver function , liver function tests , immunology , virus , helicobacter pylori
Summary Background : The 13 C‐caffeine breath test is a non‐invasive, quantitative test of liver function. Aim : To determine the utility of the 13 C‐caffeine breath test in chronic hepatitis B virus and its ability to monitor response to lamivudine. Methods : Forty‐eight chronic hepatitis B virus patients and 24 controls underwent the 13 C‐caffeine breath test. In 28 patients commenced on lamivudine, 13 C‐caffeine breath tests were performed at 1 week ( n = 12) and after 1 year of therapy. Results : Patients with Metavir F0–1 fibrosis (2.30 ± 1.02 Δ‰ per 100 mg caffeine) had a 13 C‐caffeine breath test similar to controls (2.31 ± 0.85, P = 0.96). However, patients with F2–3 fibrosis (1.59 ± 0.78, P = 0.047) and cirrhotic patients (0.99 ± 0.33, P = 0.001) had a decreased 13 C‐caffeine breath test. Fibrosis correlated best with the 13 C‐caffeine breath test ( r s = −0.62, P < 0.001). The 13 C‐caffeine breath test independently predicted significant (F ≥ 2) and advanced (F ≥ 3) fibrosis and yielded the greatest area under the receiver operating characteristic curve (0.91 ± 0.04) for predicting advanced fibrosis. The 13 C‐caffeine breath test was unaltered by 1 week of lamivudine but improved by 61% ( P < 0.001) in responders to long‐term lamivudine, whereas in those with viraemia and elevated alanine aminotransferase, values remained stable or deteriorated. Conclusion : The 13 C‐caffeine breath test distinguishes chronic hepatitis B virus‐related fibrosis and detects improvement in liver function in response to long‐term lamivudine.