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Long-term lamivudine therapy in chronic hepatitis B
S Lingala1, D T-Y Lau2, C Koh1
1Liver Diseases Branch, Intramural Division, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD, USA.
Alimentary Pharmacology & Therapeutics
|July 5, 2016
Summary
Long-term lamivudine therapy for chronic hepatitis B can lead to HBsAg loss, especially in HBeAg-negative patients. Serious outcomes are primarily seen in those with cirrhosis who do not achieve HBsAg clearance.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Background:
- Chronic hepatitis B (CHB) treatment with oral nucleoside analogues for 1-5 years shows clinical benefits.
- Long-term effects of CHB therapy are not well-defined.
Purpose of the Study:
- To assess outcomes of CHB patients undergoing long-term lamivudine therapy.
Main Methods:
- Followed 42 CHB patients treated with lamivudine for a median of 16.1 years.
- Switched therapy for 16 patients due to lamivudine resistance and disease relapse.
Main Results:
- HBsAg loss occurred in 77% of HBeAg-positive and 50% of HBeAg-negative patients.
- Lamivudine resistance developed in 57% of patients; 25% of these lost HBsAg.
- HBsAg loss enabled therapy cessation with no relapse; 26% of HBsAg-positive patients with cirrhosis faced severe outcomes.
Conclusions:
- Long-term nucleoside analogue therapy promotes HBsAg loss in a significant CHB patient proportion.
- Pre-existing cirrhosis without HBsAg clearance during treatment is linked to serious outcomes.
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