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Lamivudine monotherapy in children with immune-tolerant chronic hepatitis B virus

R Artan1

  • 1Akdeniz University Faculty of Medicine, Department of Pediatric Gastroenterology Hepatology and Nutrition, Antalya, Turkey. artan@akdeniz.edu.tr

Journal of Chemotherapy (Florence, Italy)
|June 1, 2005
PubMed

Insights

Lamivudine treatment did not achieve sustained viral control in children with immune-tolerant chronic hepatitis B. While patients initially cleared hepatitis B virus DNA, it returned, indicating lamivudine is ineffective for long-term viral suppression in this group.

Area of Science:

  • Hepatology
  • Virology
  • Pediatric Infectious Diseases

Background:

  • Chronic hepatitis B (CHB) infection in pediatric patients with immune tolerance presents unique treatment challenges.
  • Assessing antiviral efficacy in this specific population is crucial for guiding therapeutic strategies.

Purpose of the Study:

  • To evaluate the effectiveness of lamivudine in achieving a primary and sustained virological response in naive pediatric patients with immune-tolerant CHB.
  • To determine if lamivudine can induce long-term viral control in this patient cohort.

Main Methods:

  • A cohort of 17 naive pediatric patients with immune-tolerant CHB received lamivudine (max 100 mg/day) for an average of 35 months (range 16-60 months).
  • A control group of 6 untreated patients was monitored.
  • Hepatitis B virus (HBV) DNA levels and liver histology were assessed. Safety was monitored through adverse event reporting.

Main Results:

  • All treated patients achieved HBV DNA negativity by month 12 (average 7 months), but none sustained this response, with viral rebound occurring by month 20 (average).
  • No spontaneous HBV DNA clearance or HBe seroconversion was observed in untreated patients.
  • One treated patient showed significant improvement in liver histology; no adverse events were reported.

Conclusions:

  • Lamivudine treatment does not induce primary or sustained viral control in pediatric patients with immune-tolerant CHB.
  • The drug is unlikely to achieve complete viral suppression in this specific demographic.
  • Further research into alternative or combination therapies is warranted for this population.

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