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
Article
in English
| LILACS
| ID: lil-266051
Responsible library:
BR1.1
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.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Health and Well-Being
Health problem:
Target 3.3: End transmission of communicable diseases
Database:
LILACS
Main subject:
Lamivudine
/
Anti-HIV Agents
/
Hepatitis B, Chronic
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
Language:
English
Journal:
Rev. Inst. Med. Trop. Säo Paulo
Journal subject:
Tropical Medicine
Year:
2000
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Instituto Adolfo Lutz/BR
/
Laboratório Bioquímico Jardim Paulista/BR
/
Universidade de São Paulo/BR