Early virological response predicts outcome during extended lamivudine retreatment in patients with chronic hepatitis B who relapsed after initial HBeAg responses

Authors

  • JEONG WON JANG,

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • SI HYUN BAE,

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • JONG YOUNG CHOI,

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • CHANG WOOK KIM,

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • NAM IK HAN,

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • JUN YEOL HAN,

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • SANG WOOK CHOI,

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • SEUNG KEW YOON,

    Corresponding author
    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • KYU WON CHUNG,

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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  • HEE SIK SUN

    1. Department of Internal Medicine and WHO Collaborating Center on Viral Hepatitis, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Professor Seung Kew Yoon, Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, ♯505 Banpodong, Seocho-ku, 137-040, Seoul, Korea. Email: yoonsk@catholic.ac.kr

Abstract

Background and Aim:  Studies from hepatitis B virus endemic areas have shown less durable lamivudine-induced responses and have raised issues about the management of a post-treatment relapse.

Methods:  From January 2000 to June 2004, all 51 patients (43 HBeAg-positive and eight HBeAg-negative) were retreated with lamivudine for at least 12 months. All had a post-treatment relapse after HBeAg responses (HBeAg loss/seroconversion) during the first therapy.

Results:  During retreatment, HBeAg seroconversion occurred more frequently in those patients with HBeAg seroconversion than in those with HBeAg loss alone during prior lamivudine therapy (= 0.001). On multivariate analysis, prior HBeAg seroconversion and early virological response (EVR) (≤ 2 months of retreatment) independently predicted HBeAg seroconversion (= 0.012 and P = 0.004, respectively). With regard to virological breakthrough, only the time to virological response (> 2 months of retreatment) remained significant (= 0.048). Among the HBeAg-negative patients, virological breakthrough occurred in only one patient with a late virological response.

Conclusions:  EVR is a major predictor in determining a favorable response to lamivudine retreatment. Our observations suggest that lamivudine retreatment will provide more therapeutic gains in those patients with a prior HBeAg seroconversion than in those with HBeAg loss alone.

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