A study on efficacy of lamivudine therapy in decompensated cirrhosis of liver due to chronic hepatitis B virus infection.

ABSTRACT

The prognosis of decompensated cirrhosis of liver resulting from chronic Hepatitis B Virus (HBV) infection is poor and liver transplantation is the only established mode of treatment. The benefits of treatment with interferon are outweighed by serious side effects and risks of fatal exacerbation of disease activity. Lamivudine rapidly reduces hepatitis B viral DNA in serum to undetectable levels. The purpose of this study was to evaluate effectiveness and safety of Lamivudine treatment in patients with advanced and end stage liver disease caused by Hepatitis B. This was a prospective observational study in which a total of 45 patients, 39 (87.0%) male and 6 (13.0%) female who had viral activity and child pugh score e" 8 were given Lamivudine 100 mg orally once daily. Among them 30 patients completed at least 6 months of therapy, majority (27 patients) showed improvement in liver function with decrease in serum ALT from mean (+/- SD) 118.8 +/- 106.5 to 50.2 +/- 57.1 U/L (p < 0.001), decrease in serum bilirubin from 73.9 +/- 80.5 to 44.7 +/- 62.9 micromol/l (p = 0.129), increase in serum albumin from 26.2 +/- 4.2 to 33.2 +/- 3.4 g/l (p < 0.05), decrease in prothrombin time from 8.3 +/- 4.0 to 3.9 +/- 2.9 seconds prolonged (p < 0.05) and reduction in child pugh score from 11.0 +/- 1.7 to 7.0 +/- 1.3 (p < 0.001). Seroconversion was found in 5 (11.1%) patients on Intention to treat analysis. Among the seroconverted group, 1 (2.2%) patient also lost HBsAg. Six (13.0%) patient had procore mutant virus, 2 (4.4%) of them showed virological response. Therefore, total 7 (15.5%) patients showed virological response by intention to treat analysis. We conclude that inhibition of viral replication with Lamivudine results in a significant improvement of liver function in patients with decompensated cirrhosis of liver due to HBV infection.