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Individual prediction model for lamivudine treatment response in hepatitis B virus e antigen-positive chronic hepatitis B patients

Authors
 Hyun Woong Lee  ;  Wonseok Kang  ;  Sang Hoon Ahn  ;  Heon Ju Lee  ;  Jae Seok Hwang  ;  Joo Hyun Sohn  ;  Jae Young Jang  ;  Ki Jun Han  ;  Ja Kyung Kim  ;  Do Young Kim  ;  Yong Han Paik  ;  Chun Kyon Lee  ;  Ik-Seong Choi  ;  Kwan Sik Lee  ;  Kwang-Hyub Han 
Citation
 Journal of Gastroenterology and Hepatology, Vol.29(5) : 1049-1055, 2014 
Journal Title
 Journal of Gastroenterology and Hepatology 
ISSN
 0815-9319 
Issue Date
2014
MeSH
Adult ; Aged ; Biomarkers/blood ; Female ; Forecasting ; Hepatitis B e Antigens/blood* ; Hepatitis B, Chronic/drug therapy* ; Hepatitis B, Chronic/immunology* ; Humans ; Lamivudine/therapeutic use* ; Male ; Middle Aged ; Multicenter Studies as Topic ; Retrospective Studies ; Treatment Outcome ; Young Adult
Keywords
chronic hepatitis B ; lamivudine ; treatment
Abstract
BACKGROUND AND AIMS: Although prolonged lamivudine (LAM) therapy is associated with the emergence of LAM-resistant mutations, it is still a commonly used therapy in many Asian countries because of its established long-term safety and low cost. The aim of our study was to assess the predictors of long-term LAM treatment response and to establish an individual prediction model (IPM) for hepatitis B virus e antigen (HBeAg) seroconversion in HBeAg-positive chronic hepatitis B (CHB) patients. METHODS: This was a multicenter analysis of 838 patients treated with LAM between January 1999 and August 2004. Of these, 748 patients were followed up for at least 24 months. RESULTS: The median age was 43.0 years (range, 19-79 years) and the mean duration of LAM monotherapy was 34.2 ± 0.7 months. In the multivariate analysis, age (odds ratio [OR] = 0.974, P < 0.001), baseline alanine aminotransferase level (OR = 1.001, P = 0.014), and baseline hepatitis B virus DNA level (OR = 0.749, P < 0.001) were independent factors for HBeAg seroconversion. Based on the predictors, an IPM was established. Patients were classified into high (> 50%), intermediate (30-50%), or low (≤ 30%) response groups based on their probability of HBeAg seroconversion according to the IPM. The cumulative HBeAg seroconversion rate at 6 years for the high, intermediate, and low response groups was 66.0%, 48.5%, and 21.8%, respectively (P < 0.001). CONCLUSIONS: An IPM was developed based on predictors of HBeAg seroconversion in HBeAg-positive CHB patients on LAM monotherapy. This model will allow screening of LAM responders prior to the commencement of antiviral treatment.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/jgh.12522/abstract
DOI
10.1111/jgh.12522
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강원석(Kang, Won Suk)
김도영(Kim, Do Young)
김자경(Kim, Ja Kyung) ORCID logo https://orcid.org/0000-0001-5025-6846
백용한(Paik, Yong Han)
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
이관식(Lee, Kwan Sik) ORCID logo https://orcid.org/0000-0002-3672-1198
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/158608
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