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High risk of hepatocellular carcinoma in anti‐HBe positive liver cirrhosis patients developing lamivudine resistance
Author(s) -
Andreone P.,
Gramenzi A.,
Cursaro C.,
Biselli M.,
Cammà C.,
Trevisani F.,
Bernardi M.
Publication year - 2004
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2004.00564.x
Subject(s) - lamivudine , hepatocellular carcinoma , cirrhosis , medicine , gastroenterology , hepatitis b virus , hepatitis b , virus , virology
Summary. The emergence of drug‐resistant virus in hepatitis B virus patients treated with lamivudine is well documented. However, its clinical impact in the long‐term treatment of anti‐HBe positive compensated cirrhotic patients is not well known. In this study, we treated 22 consecutive patients with anti‐HBe compensated cirrhosis with lamivudine for a median period of 42 months. All patients responded to lamivudine, but viral breakthrough occurred in 13 patients (59%) between 9 and 42 months of therapy due to the emergence of a mutant strain. During the follow‐up, 11 developed hepatocellular carcinoma. Of these, 10 occurred soon after the emergence of viral resistance, generally showing aggressive behaviour, and one in the nine long‐term responder patients ( P = 0.013). Lamivudine resistance was the only independent predictor of hepatocellular carcinoma development (risk ratio: 10.4; 95% CI: 1.3–84.9). Our study suggests that the occurrence of lamivudine resistance increases the risk of hepatocellular carcinoma in anti‐HBe positive cirrhosis and warrants further research.