Lamivudine therapy in patients with decompensated cirrhosis-a 3-year follow-up study / 中华临床感染病杂志

ABSTRACT

Objective To evaluate the efficacy of long-term lamivudine therapy in patients with decompensated cirrhosis after HBV infection. Methods The clinical courses and outcomes of lamivudine therapy in 60 patients with decompensated cirrhosis were observed and the results were compared with those in historical control group who did not receive lamivudine therapy. Kaplan-Meier method was used to measure the survival rates of two groups. Results There was significant improvement of Child scores in the treatment group, which were 9.4±2.4 at the baseline and 8.3±1.8, 6.5±2.2, 6.3±0.7 at 12 months,24 months and 36 months of the therapy (P<0.01), respectively. Significant clinical improvements were observed in 20 patients in the treatment group, but no improvement was observed in the controls. The rates of serum HBV DNA clearance was 84.7% (50/59), 89.2% (50/56), 76.8% (40/52) and 72%(36/50) at 6 months, 12 months, 24 months and 36 months of the therapy. And the rates of YMDD mutant were 0, 7% (4/56), 17.3% (9/52) and 26% (13/50) at these time points. The survival rates for the treatment group were 77.7%, 50% and 46. 5% at 1 year, 2 year and 3 year, while those in the control group were 71.28%, 45% and 43.5%, the difference was of no statistical significance (P=0.12).Conclusion Lamivudine therapy can significantly improve the liver function in patients with decompensated cirrhosis, but it may not improve the survival of patients.