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The
Role of Genotype and Drug Resistance in the Response to Long-term
Lamivudine Treatment in Patients with Severe Chronic Hepatitis B
Lamivudine
(Epivir-HBV)
is effective in suppressing viral replication, normalizing alanine aminotransferase
(ALT), and improving histological
appearance in HBe positive and negative hepatitis.
It is unclear whether hepatitis B virus (HBV) genotype influences
the response to lamivudine.
In this retrospective review of charts of all patients
treated with lamivudine monotherapy between 1993 and 2002, researchers
describe the long-term response of patients with chronic
hepatitis B
with and without cirrhosis at baseline treated with lamivudine according to HBV
genotype.
Response to therapy was defined as ALT in the
normal range, undetectable HBV DNA, and in the HBeAg positive group
loss
of HBeAg
and/or the development of anti-HBeAg.
Results
· Seventy-one
patients treated with lamivudine for 6 months or more, 53 (75%)
were male, average age 47 years, 38 (54%) were HBeAg+ and 33
(46%) HBeAg-
· Mean
baseline HBV DNA viral titre was 1280.2 copies/mL and 518 copies/mL
respectively.
· Cirrhosis was present in 30 (42%).
· Sera
were examined for YMDD
mutations
at last patient visit in 61 (86%), and were detected in 45 (74%),
there being no association with a particular genotype.
· Data
from up to 5 years on lamivudine indicated no difference in
biochemical or virological response between genotypes.
· Cirrhosis
was more prevalent with specific genotypes.
The researchers found no influence of HBV genotype on the development
of resistance to lamivudine, however liver
disease severity was influenced by genotype.
07/11/04
Reference
D
N Moskovitz and others. Response to long-term lamivudine
treatment (up to 5 years) in patients with severe chronic hepatitis
B, role of genotype and drug resistance. Journal of Viral Hepatitis
12(4): 398-404. July 2005.
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