Factors related to post-treatment relapse in chronic hepatitis B patients who lost HBeAg after lamivudine therapy
- Byun, Kwan Soo; Kwon, Oh Sang; Kim, Ju Hyun; Yim, Hyung Joon; Chang, Yun Jung; Kim, Jin Yong; Yeon, Jong Eun; Park, Jong Jae; Kim, Jae Seon; Bak, Young Tae; Lee, Chang Hong
- Issue Date
- Blackwell Publishing Inc.
- Chronic hepatitis B; Lamivudine; Relapse
- Journal of Gastroenterology and Hepatology, v.20, no.12, pp.1838 - 1842
- Journal Title
- Journal of Gastroenterology and Hepatology
- Start Page
- End Page
- Background and Aim: It is uncertain if a patient's lamivudine response after HBeAg loss is durable. In Korean chronic hepatitis B patients, the relapse rate is high after termination of lamivudine therapy for patients with HBeAg loss. We evaluated the factors related to relapse in chronic hepatitis B patients with HBeAg loss after lamivudine therapy.
Methods: A total of 132 chronic hepatitis B patients, who initially had HBeAg and did not have decompensated features, were analyzed in this study. These patients lost the HBeAg after lamivudine therapy and then their therapy was stopped. Post-treatment serum alanine aminotransferase (ALT), HBeAg, anti-HBe and hepatitis B virus (HBV) DNA were monitored until relapse.
Results: Seventy-five patients relapsed (cumulative relapse rate: 56% at 6 months). Upon univariate analysis, the factors of age, serum total bilirubin, presence of anti-HBe after HBeAg loss, and the duration of additional lamivudine therapy after HBeAg loss were associated with relapse. Upon multivariate analysis, older age, a higher serum total bilirubin and the shorter duration of additional lamivudine therapy were significant risk factors for relapse. Patterns of relapse were the re-elevation of ALT, re-emergence of HBV DNA (69 patients) and reappearance of HBeAg (55 patients).
Conclusions: To prevent relapse in patients with chronic hepatitis B infection after lamivudine therapy, age and serum bilirubin level of patients as well as a prolonged duration of additional lamivudine therapy should be considered.
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- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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