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Lamivudine maintenance beyond one year after HBeAg seroconversion is a major factor for sustained virologic response in HBeAg-positive chronic hepatitis B

Authors
 Hyun Woong Lee  ;  Heon Ju Lee  ;  Jae Seok Hwang  ;  Joo Hyun Sohn  ;  Jae Young Jang  ;  Ki Jun Han  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Yong Han Paik  ;  Chun Kyon Lee  ;  Kwan Sik Lee  ;  Chae Yoon Chon  ;  Kwang-Hyub Han 
Citation
 HEPATOLOGY, Vol.51(2) : 415-421, 2010 
Journal Title
 HEPATOLOGY 
ISSN
 0270-9139 
Issue Date
2010
MeSH
Adult ; Aged ; Female ; Hepatitis B e Antigens/blood* ; Hepatitis B, Chronic/blood* ; Hepatitis B, Chronic/drug therapy* ; Hepatitis B, Chronic/immunology ; Hepatitis B, Chronic/virology ; Humans ; Lamivudine/administration & dosage* ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Young Adult
Abstract
The reported durability of virologic response after successful lamivudine monotherapy is variable, and the question remains as to whether virologic responses can be maintained over an extended follow-up period. The aim of this study was to investigate posttreatment durability, the optimal duration of additional treatment after HBeAg clearance or seroconversion, and determinants for sustained virologic response (SVR) following lamivudine monotherapy in patients with HBeAg-positive chronic hepatitis B (CHB). From January 1999 to August 2004, 178 Korean patients with HBeAg-positive CHB were treated with lamivudine and achieved complete responses, defined as a loss of serum HBeAg and hepatitis B virus DNA, and alanine aminotransferase normalization. The mean duration of lamivudine monotherapy was 26 months (range, 12-77). SVR was maintained in 138 patients (77.5%). Host and viral factors were compared between 138 patients with SVR and 40 patients whose response was not sustained. The cumulative relapse rates increased from 15.9% at 1 year to 30.2% at 5 years, with a mean time to relapse after cessation of lamivudine of 12 months (range, 7-42). Most relapses occurred within 2 years after discontinuation of lamivudine (33/40, 82.5%). On multivariate analysis, age <or=40 years and additional treatment for more than 12 months after HBeAg clearance or seroconversion were independent factors for SVR. CONCLUSION: The lamivudine-induced virologic response was durable in patients under 40 years old and those receiving lamivudine for more than 12 months after HBeAg clearance or seroconversion. Age and additional treatment were major predictive factors for SVR
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/hep.23323/abstract
DOI
10.1002/hep.23323
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Paik, Yong Han(백용한)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Lee, Hyun Woong(이현웅) ORCID logo https://orcid.org/0000-0002-6958-3035
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100539
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