Predictive factors for response to Lamivudine in chronic hepatitis B

Revista do Instituto de Medicina Tropical de São Paulo

Luiz Caetano Da Silva²  Luís Edmundo Pinto Da Fonseca²  Flair José Carrilho²  Venâncio Avancini Ferreira Alves¹  Roberta Sitnik¹  João Renato Rebello Pinho¹ 

[1] ,Universidade de São Paulo Faculdade de Medicina Hospital das ClínicasSão Paulo SP ,Brasil

关键词: Hepatitis B;    HBV;    Lamivudine;    HBV-DNA;    PCR;    bDNA;   

DOI  :  10.1590/S0036-46652000000400003

来源: SciELO

【 摘 要 】

BACKGROUND: Lamivudine has been shown to be an efficient drug for chronic hepatitis B (CHB) treatment. AIM: To investigate predictive factors of response, using a quantitative method with high sensitivity. METHODS: We carried out a prospective trial of lamivudine in 35 patients with CHB and evidence for viral replication, regardless to their HBeAg status. Lamivudine was given for 12 months at 300 mg daily and 150 mg thereafter. Response was considered when DNA was undetectable by PCR after 6 months of treatment. Viral replication was monitored by end-point dilution PCR. Mutation associated with resistance to lamivudine was detected by DNA sequencing in non-responder patients. RESULTS: Response was observed in 23/35 patients (65.7%) but only in 5/15 (33.3%) HBeAg positive patients. Only three pre-treatment variables were associated to low response: HBeAg (p = 0.006), high viral load (DNA-VHB > 3 x 10(6) copies/ml) (p = 0.004) and liver HBcAg (p = 0.0028). YMDD mutations were detected in 7/11 non-responder patients. CONCLUSIONS: HBeAg positive patients with high viral load show a high risk for developing drug resistance. On the other hand, HBeAg negative patients show a good response to lamivudine even with high viremia.

【 授权许可】

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