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Title: Four years of lamivudine treatment in Chinese patients with chronic hepatitis B
Authors: Chang, T.-T.
Lai, C.-L.
Chien, R.-N.
Guan, R. 
Lim, S.-G. 
Lee, C.-M.
Ng, K.-Y. 
Nicholls, G.J.
Dent, J.C.
Leung, N.W.Y.
Keywords: Chinese
Chronic hepatitis B
Issue Date: Nov-2004
Citation: Chang, T.-T., Lai, C.-L., Chien, R.-N., Guan, R., Lim, S.-G., Lee, C.-M., Ng, K.-Y., Nicholls, G.J., Dent, J.C., Leung, N.W.Y. (2004-11). Four years of lamivudine treatment in Chinese patients with chronic hepatitis B. Journal of Gastroenterology and Hepatology (Australia) 19 (11) : 1276-1282. ScholarBank@NUS Repository.
Abstract: Background and Aims: This study assessed the efficacy and safety of up to 4 years of lamivudine treatment and the clinical relevance of the emergence of YMDD-variant hepatitis B virus (HBV). Methods: Fifty-eight Chinese adult patients with chronic hepatitis B (CHB) were randomized to lamivudine 100 mg/day for up to 5 years and were monitored for YMDD-variant HBV, hepatitis B e antigen (HBeAg) seroconversion (loss of HBeAg and detectable antibody to HBeAg) and serum alanine aminotransferase (ALT) concentrations. Four-year data are reported here. Results: The rate of HBeAg seroconversion increased with extended therapy and also with higher baseline ALT concentrations. YMDD-variant HBV was detected in 67% (39/58) of patients at some point during treatment. After 4 years, a total of 47% (27/58) of patients achieved HBeAg seroconversion. Thirty-three per cent (13/39) of patients with YMDD-variant HBV achieved HBeAg seroconversion; this increased to 57% (8/14) in patients with moderately elevated (>2-5 × upper limit of normal) pre-treatment ALT concentrations. The proportion of patients that achieved normal serum ALT increased from 29% (17/58) at baseline to 69% (31/45) following 4 years of treatment. That included 68% (23/34) of patients with YMDD-variant HBV and 73% (8/11) of those without the variant. All patients receiving lamivudine had reduced serum concentrations of HBV-DNA compared with baseline, despite the emergence of YMDD-variant HBV in 39 patients. Lamivudine was generally well tolerated; there was little change in the number or type of drug-related adverse events in the fourth year of the study. Conclusions: Despite the emergence of YMDD-variant HBV, Chinese patients showed increased HBeAg seroconversion and improvement in ALT levels with an increased duration of treatment with lamivudine. © 2004 Blackwell Publishing Asia Pty Ltd.
Source Title: Journal of Gastroenterology and Hepatology (Australia)
ISSN: 08159319
DOI: 10.1111/j.1440-1746.2004.03428.x
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