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Cited 2 time in webofscience Cited 4 time in scopus
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Clinical outcomes of chronic hepatitis B patients with persistently detectable serum hepatitis B virus DNA during lamivudine therapy

Authors
Kim, Ji H.Yu, Sang K.Seo, Yeon S.Yim, Hyung J.Yeon, Jong E.Park, Jong J.Kim, Jae S.Bak, Young T.Lee, Chang H.Byun, Kwan S.
Issue Date
Aug-2007
Publisher
WILEY
Keywords
chronic hepatitis 3; hepatitis B virus DNA; lamivudine
Citation
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.22, no.8, pp.1220 - 1225
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume
22
Number
8
Start Page
1220
End Page
1225
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/17817
DOI
10.1111/j.1440-1746.2007.04921.x
ISSN
0815-9319
Abstract
Background and Aim: A small proportion of chronic hepatitis B patients have persistently detectable serum hepatitis B virus (HBV) DNA despite lamivudine therapy. The incidence and clinical outcomes of patients who persistently have detectable serum HBV-DNA during lamivudine therapy was investigated. Method: We enrolled 221 chronic hepatitis B patients who underwent lamivudine therapy for more than 6 months. Among them, 180 were HBeAg positive. Serum HBV-DNA, HBeAg, anti-HBe and alanine aminotransferase (ALT) levels were serially monitored. The study groups were defined, using a hybridization assay, as patients with reductions in serum HBV-DNA below the detectable level (group I) or patients with persistently detectable serum HBV-DNA (group II) during the initial 6 months of lamivudine therapy. Results: The incidence of patients who had persistently detectable HBV-DNA was 7.7%. After the first year, the rates of viral breakthrough, HBeAg loss and serum ALT normalization of group I versus group II were 21% versus 63%, 38% versus 0%, and 71% versus 28%, respectively (P < 0.001). The login reduction of serum HBV-DNA at 6 months was -4.58 log(10) for group I and -1.97 log(10) for group II (P < 0.001, bDNA assay). There were no pretreatment lamivudine-resistant mutants in group II. Conclusion: Lamivudine had little effect on serum HBV-DNA suppression, viral breakthrough suppression and rate of HBeAg loss and ALT normalization in chronic hepatitis B patients with persistently detectable serum HBV-DNA during the initial 6 months of therapy. Early termination of lamivudine therapy is advocated for these patients.
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Kim, Jae Seon
Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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