The Clinical Meaning of the Emergence of Viral Breakthrough during Lamivudine Treatment in Patients with Hepatitis B Virus Related Chronic Liver Disease / 대한간학회지
The Korean Journal of Hepatology
;
: 108-116, 2004.
Article
in Korean
| WPRIM
| ID: wpr-122265
ABSTRACT
BACKGROUND/AIMS:
Viral breakthrough has been considered a major limitation of lamivudine in the treatment of hepatitis B virus related chronic liver disease. Its clinical meaning has not been thoroughly assessed.METHODS:
64 patients who showed viral breakthrough during lamivudine treatment were retrospectively reviewed. We evaluated the rate of HBeAg seroconversion and hepatic decompensation after viral breakthrough.RESULTS:
After viral breakthrough, serum alanine transaminase (ALT) elevation more than 1.2X upper limit of normal (ULN) was noticed in 40 patients (62.5%). Acute flare (serum ALT elevation >X5 ULN, or serum bilirubin >3 mg/dL) occured in 15 patients (23.4%). During the period of follow up (15.0 +/- 9.7 months; range, 0-31 months) since viral breakthrough, decreased serum HBV-DNA level to below the detection limit and serum ALT normalization was seen in 15 patients (23.4%). HBeAg seroconversion was noticed in 7 (13.7%) of a total of 51 HBeAg positive patients at base line; in 4 (15.4%) of 26 patients with non-hepatic failure (chronic hepatitis or Child-Pugh class A liver cirrhosis) at base line; and in 2 (40.0%) of 5 patients with non-hepatic failure at base line and acute flare after viral breakthrough. During this period, terminal hepatic decompensation (Child-Pugh class C) or death was noticed in 9 (90.0%) of 10 patients who had hepatic decompensation (Child-Pugh class B or C) at baseline and acute flare after viral breakthrough.CONCLUSIONS:
Acute flare after viral breakthrough seemed to continue during HBeAg seroconversion and rarely developed into terminal hepatic decompensation or death in patients with non-hepatic decompensation at baseline. Its incidence is not only high but lethal to most patients with hepatic decompensation at baseline.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Antiviral Agents
/
English Abstract
/
DNA, Viral
/
Hepatitis B virus
/
Acute Disease
/
Reverse Transcriptase Inhibitors
/
Lamivudine
/
Hepatitis B, Chronic
/
Hepatitis B e Antigens
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
Korean
Journal:
The Korean Journal of Hepatology
Year:
2004
Type:
Article
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