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Title: Outcome of lamivudine-resistant hepatitis B virus is generally benign except in cirrhotics
Authors: Dan, Y.-Y. 
Wai, C.-T. 
Lee, Y.-M. 
Sutedja, D.S.
Seet, B.-L.
Lim, S.-G. 
Keywords: Hepatitis B treatment
Lamivudine resistance
Nucleoside analog
YMDD mutants
Issue Date: 28-Jul-2005
Citation: Dan, Y.-Y., Wai, C.-T., Lee, Y.-M., Sutedja, D.S., Seet, B.-L., Lim, S.-G. (2005-07-28). Outcome of lamivudine-resistant hepatitis B virus is generally benign except in cirrhotics. World Journal of Gastroenterology 11 (28) : 4344-4350. ScholarBank@NUS Repository.
Abstract: Aim: We set to determine factors that determine clinical severity after the development of resistance. Methods: Thirty-five Asian patients with genotypic lamivudine resistance were analyzed in three groups: 13/35 (37%) were non-cirrhotics with normal pre-treatment ALT (Group IA), 12/35 (34%) were non-cirrhotics with elevated pre-treatment ALT (Group IB), and 10/35 (29%) were cirrhotics (Group II). Patients were followed for a median of 98 wk (range 26-220) after the emergence of genotypic resistance. Results: Group IA patients tended to retain normal ALT. Group IB patients showed initial improvement of ALT with lamivudine but 9/12 patients (75%) developed abnormal ALT subsequently. On follow-up however, this persisted in only 33%. Group II patients also showed improvement while on treatment, but they deteriorated with the emergence of resistance with 30% death from decompensated liver disease. Pretreatment ALT levels and CPT score (in the cirrhotic group) were predictive of clinical resistance and correlated with peak ALT levels and CPT score. Conclusion: The phenotype of lamivudine-resistant HBV correlated with the pretreatment phenotype. The clinical course was generally benign in non-cirrhotics. However, cirrhotics had a high risk of progression and death (30%) with the development of lamivudine resistance. © 2005 The WJG Press and Elsevier Inc. All rights reserved.
Source Title: World Journal of Gastroenterology
ISSN: 10079327
Appears in Collections:Staff Publications

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