Predictive factors for response to lamivudine in chronic hepatitis B
Rev. Inst. Med. Trop. Säo Paulo
;
42(4): 189-96, July-Aug. 2000. tab, graf
Artículo
en Inglés
| LILACS
| ID: lil-266051
ABSTRACT
BACKGROUND:
Lamivudine has been shown to be an efficient drug for chronic hepatitis B (CHB) treatment.AIM:
To investigate predictive factors of response, using a quantitative method with high sensitivity.METHODS:
We carried out a prospective trial of lamivudine in 35 patients with CHB and evidence for viral replication, regardless to their HBeAg status. Lamivudine was given for 12 months at 300 mg daily and 150 mg thereafter. Response was considered when DNA was undetectable by PCR after 6 months of treatment. Viral replication was monitored by end-point dilution PCR. Mutation associated with resistance to lamivudine was detected by DNA sequencing in non-responder patients.RESULTS:
Response was observed in 23/35 patients (65.7 per cent) but only in 5/15 (33.3 per cent) HBeAg positive patients. Only three pre-treatment variables were associated to low response HBeAg (p = 0.006), high viral load (DNA-VHB > 3 x 10(6) copies/ml) (p = 0.004) and liver HBcAg (p = 0.0028). YMDD mutations were detected in 7/11 non-responder patients.CONCLUSIONS:
HBeAg positive patients with high viral load show a high risk for developing drug resistance. On the other hand, HBeAg negative patients show a good response to lamivudine even with high viremia.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Lamivudine
/
Fármacos Anti-VIH
/
Hepatitis B Crónica
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Adolescente
/
Adulto
/
Niño
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Rev. Inst. Med. Trop. Säo Paulo
Asunto de la revista:
Medicina Tropical
Año:
2000
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Instituto Adolfo Lutz/BR
/
Laboratório Bioquímico Jardim Paulista/BR
/
Universidade de São Paulo/BR
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