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Factors associated with response to lamivudine: Retrospective study in a tertiary care clinic serving patients with chronic hepatitis B
Author(s) -
HANN HIEWON L,
JONSSON FUNK MICHELE L,
ROSENBERG DANIEL M,
DAVIS RANDY
Publication year - 2005
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2005.03577.x
Subject(s) - medicine , lamivudine , hbeag , gastroenterology , hbsag , hepatocellular carcinoma , retrospective cohort study , liver disease , chronic hepatitis , hepatitis b , proportional hazards model , immunology , hepatitis b virus , virus
Background and Aims: Chronic hepatitis B (CHB) is an important cause of end stage liver disease and hepatocellular carcinoma. Controlled clinical trials indicate treatment with lamivudine results in positive clinical responses. The study goal was to determine if the response to lamivudine treatment (HBeAg loss, HBV DNA loss and alanine aminotransferase [ALT] reduction) differs according to pretherapy (pre‐tx) ALT levels. Methods: This was a retrospective review of medical record data. All CHB patients at all stages of disease (including cirrhotic) with more than two visits to the clinic were included in the study ( n = 719). Kaplan‐Meier survival and Cox proportional hazards were estimated. Results: Of the total 719 HBsAg (+) patients, 317 were treated with lamivudine 150 mg or 100 mg daily. Among HBeAg positive patients, at 3 years, Kaplan‐Meier estimates of the loss of HBeAg were 40%, 57% and 61% for pre‐tx ALT < upper limit of normal (ULN), 1–2 × ULN and >2 × ULN, respectively. Similar results of HBV‐DNA loss were seen in HBeAg negative patients. Conclusions: In this setting, we observed that pre‐tx ALT levels were not associated with response to lamivudine, but that lower platelet count and female sex in HBeAg (+) patients were important predictive factors of a favorable response to lamivudine therapy.