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Efficacy of Lamivudine Therapy and Factors Associated with Emergence of Resistance in Chronic Hepatitis B Virus Infection in Japan.
- Source :
-
Intervirology . May/Jun2003, Vol. 46 Issue 3, p182-189. 8p. 5 Charts, 1 Graph. - Publication Year :
- 2003
-
Abstract
- Objective: Several reports have examined the efficacy of long-term lamivudine therapy and the risk factors involved in emergence of viral resistance in Japanese patients with hepatitis B virus (HBV) infection. However, the patient cohorts in such studies are relatively small. Methods: We analyzed 234 chronically HBV-infected Japanese patients who were treated with lamivudine for more than 12 months. They comprised patients with HBV genotype A (n = 8), genotype B (n = 21), genotype C (n = 203) and other HBV genotypes (n = 2). Results: In most patients, lamivudine resulted in normalization of alanine transaminase (ALT) levels at 6 and 12 months, and suppression of serum HBV DNA to undetectable levels by the branched chain DNA probe assay (bDNA). Rates of ALT normalization and non-detection of HBV DNA were higher among patients with genotype B than genotype C disease. The proportions of patients who achieved HBeAg loss were 27, 42 and 45% after 6 months, 1 year and 2 years, respectively. The emergence of mutations was not different among genotypes A, B and C by the Kaplan-Meier method. Multivariate analyses identified high HBV DNA level (bDNA ≥ 100 MEq/ml) as an independent factor associated with emergence of the YMDD motif mutation in all patients. Among patients with genotype C disease, which is the predominant HBV genotype in Japan, multivariate analysis also identified high HBV DNA level and HBeAg positivity as factors associated with emergence of resistance. Conclusion: Patients exhibiting these factors at the commencement of lamivudine treatment must be monitored carefully at regular intervals for emergence of viral resistance. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HEPATITIS B virus
*VIRAL hepatitis
*DRUG therapy
*DRUGS
Subjects
Details
- Language :
- English
- ISSN :
- 03005526
- Volume :
- 46
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Intervirology
- Publication Type :
- Academic Journal
- Accession number :
- 20600688
- Full Text :
- https://doi.org/10.1159/000071460