Lamivudine treatment in patients with hepatitis B virus induced liver cirrhosis

First studies have suggested a beneficial effect of lamivudine in patients with cirrhosis caused by replicating hepatitis B virus. Whether long-term lamivudine therapy is effective in HBV-related liver cirrhosis patients was prospectively evaluated.

Thirty-one patients with hepatitis B virus-related compensated/decompensated cirrhosis, all with quantitative DNA +ve by hybridization (10 HBeAg +ve, 21 anti-HBe +ve), received lamivudine 100 mg/day for average 16.3 (4-34) months.

At the end of therapy HBeAg seroconversion was observed in one patient. HBV DNA lost in all patients except two. Albumin levels increased (p<0.05). ALT levels and Child-Pugh-Turcotte scores decreased (p<0.05). Any complication related with liver cirrhosis was not observed during treatment period despite spontaneous ascitic infection in one and hepatic coma in two were occurred before therapy. Only one patient had clinical breakthrough presented by increase in ALT levels and reappearing of HBV DNA during therapy.

In patients with cirrhosis caused by replicating hepatitis B virus, prolonged therapy with lamivudine is well tolerated and resulted in improved serum biochemical values and loss of HBV DNA. Clinical improvements may also occur.