A higher alanine aminotransferase level correlates with earlier hepatitis B e antigen seroconversion in lamivudine-treated chronic hepatitis B patients

  1. Tai-Chung Tseng1,
  2. Chun-Jen Liu2,3,
  3. Chia-Chi Wang1,
  4. Pei-Jer Chen2,3,
  5. Ming-Yang Lai2,3,
  6. Jia-Horng Kao2,3,4,5,
  7. Ding-Shinn Chen2,3

Article first published online: 19 MAY 2008

DOI: 10.1111/j.1478-3231.2008.01766.x

Issue

Liver International

Liver International

Volume 28, Issue 7, pages 1034–1041, August 2008

Additional Information

How to Cite

Tseng, T.-C., Liu, C.-J., Wang, C.-C., Chen, P.-J., Lai, M.-Y., Kao, J.-H. and Chen, D.-S. (2008), A higher alanine aminotransferase level correlates with earlier hepatitis B e antigen seroconversion in lamivudine-treated chronic hepatitis B patients. Liver International, 28: 1034–1041. doi: 10.1111/j.1478-3231.2008.01766.x

Author Information

  1. 1

    Department of Internal Medicine, Division of Hepatogastroenterology, Buddhist Tzu Chi General Hospital Taipei Branch, Taipei, Taiwan

  2. 2

    Department of Internal Medicine, Division of Gastroenterology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan

  3. 3

    Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan

  4. 4

    Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan

  5. 5

    Department of Medical Research, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan

*Correspondence Prof. Jia-Horng Kao, Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, 1 Chang-Te Street, Taipei 10002, Taiwan Tel: +886 2 2312 3456 (ext) 7307 Fax: +886 2 2382 5962 e-mail: kaojh@ntu.edu.tw

Publication History

  1. Issue published online: 8 JUL 2008
  2. Article first published online: 19 MAY 2008
  3. Received 13 November 2007Accepted 24 March 2008

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Keywords:

  • alanine aminotransferase;
  • chronic hepatitis B;
  • genotype;
  • HBeAg seroconversion;
  • hepatitis B virus;
  • lamivudine;
  • viral load

Abstract

Background/Aims: A pretherapy serum alanine aminotransferase (ALT) level above five times the upper limit of normal (ULN) is known to predict hepatitis B e antigen (HBeAg) seroconversion during lamivudine therapy for chronic hepatitis B patients. However, whether an even higher pretherapy serum ALT value or other viral factors could affect treatment responses remains unclear.

Patients and methods: A total of 253 HBeAg-positive chronic hepatitis B patients who had a pretherapy serum ALT level over five times ULN and received lamivudine for 12–18 months were retrospectively collected. Among these patients, 38% had received prior lamivudine treatment. HBeAg seroconversion was the primary endpoint of treatment. Baseline clinical and viral features were compared between responders and non-responders at the end of treatment and 6 months post-treatment.

Results: At the end of therapy, the overall HBeAg seroconversion rate was 33.6%. For lamivudine-naïve patients, the HBeAg seroconversion rate was 37.8%. Subgroup analysis showed that patients with pretherapy ALT levels over 10 times ULN had a significantly higher HBeAg seroconversion rate than those with a pretherapy ALT level between five and 10 times ULN at 3 months (P=0.045) and 6 months (P=0.037) of lamivudine treatment. No significant difference was found in terms of pretherapy serum ALT values, viral load and genotypes between seroconverters and non-seroconverters.

Conclusions: For lamivudine-treated HBeAg-positive patients with pretherapy ALT levels over five times ULN, an even higher ALT level could predict earlier HBeAg seroconversion; however, neither ALT levels nor viral factors correlate with higher response rates after 12–18 months of treatment.

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