A higher alanine aminotransferase level correlates with earlier hepatitis B e antigen seroconversion in lamivudine-treated chronic hepatitis B patients
Article first published online: 19 MAY 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Volume 28, Issue 7, pages 1034–1041, August 2008
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
- Issue published online: 8 JUL 2008
- Article first published online: 19 MAY 2008
- Received 13 November 2007Accepted 24 March 2008
- alanine aminotransferase;
- chronic hepatitis B;
- HBeAg seroconversion;
- hepatitis B virus;
- viral load
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.