Histological improvement in patients with chronic hepatitis B virus infection treated with lamivudine

  1. Pieter Honkoop1,
  2. Robert A. de Man M.D.1,*,
  3. Pieter E. Zondervan2,
  4. Solko W. Schalm1

Article first published online: 10 DEC 2008

DOI: 10.1111/j.1600-0676.1997.tb00789.x

Issue

Liver

Liver

Volume 17, Issue 2, pages 103–106, April 1997

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How to Cite

Honkoop, P., de Man, R. A., Zondervan, P. E. and Schalm, S. W. (1997), Histological improvement in patients with chronic hepatitis B virus infection treated with lamivudine. Liver, 17: 103–106. doi: 10.1111/j.1600-0676.1997.tb00789.x

Author Information

  1. 1

    Department of Internal Medicine II (Section Hepatology), Erasmus University Hospital, Rotterdam, The Netherlands

  2. 2

    Department of Pathology, Erasmus University Hospital, Rotterdam, The Netherlands

*Department of Gastroenterology and Hepatology (Room Ca 326), Erasmus University Hospital Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands

Publication History

  1. Issue published online: 10 DEC 2008
  2. Article first published online: 10 DEC 2008
  3. Received 17 June 1996, accepted for publication 13 January 1997

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Keywords:

  • antiviral treatment;
  • hepatitis B;
  • histology;
  • lamivudine

Abstract: Lamivudine is an oral nucleoside analogue with strong antiviral activity against hepatitis B virus (HBV). In previous clinical studies, a course of lamivudine for 4–12 weeks induced a profound decrease in HBV viraemia with excellent tolerance, but data on histology have not yet been reported. We studied the liver histology of 13 patients with stable chronic HBV infection treated with 25 mg, 100 mg or 300 mg lamivudine daily for 6 months. All patients became HBV-DNA negative during treatment. The paired biopsies taken at entry and during treatment were scored by two independent observers, using the components of the histology activity index (HAI) and fibrosis (modified Knodell). The items scored were piecemeal necrosis, focal necrosis, confluent necrosis, portal inflammation and fibrosis. Before treatment, the biopsies yielded a mean HAI of 4.4 (±0.8), which decreased to HAI 2.8 (±0.5) during treatment. An analysis of the individual components of the classification system showed a significant decrease in piecemeal necrosis from a pre-treatment 1.4 (±0.3) to 0.8 (±0.1) during treatment (p=0.02). Although a trend was found for the other components, it was not statistically significant, probably due to the number of pairs examined. In conclusion these results suggest that prolonged suppression of viral replication by lamivudine can improve liver histology. In contrast to previously published reports on α-interferon therapy, this study indicates that the improvement in liver histology with lamivudine is independent of HBe-seroconversion.

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