Analysis of clinical, biochemical and viral factors associated with early relapse after lamivudine treatment for hepatitis B e antigen-negative chronic hepatitis B patients in Taiwan

Y. H. Huang, Jaw Ching Wu, Ting-Tsung Chang, I. J. Sheen, P. C. Lee, T. I. Huo, C. W. Su, Y. J. Wang, F. Y. Chang, S. D. Lee

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Abstract

The efficacy of lamivudine for HBeAg-negative chronic hepatitis B (CHB) Chinese patients has not been fully investigated. The role of the Hepatitis B virus (HBV) genotype on the treatment effect of lamivudine is controversial. Thirty-two consecutive patients with HBeAg-negative CHB were enrolled. All patients were treated with lamivudine 100 mg once daily of 7-12 months duration. The mean total period of follow-up since entry for all patients was 24 ± 3.5 months. HBV genotypes were classified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and verified by sequencing. Precore (G1896A) and basic core promoter (BCP, A1762T & G1764A) mutations were determined by PCR and direct sequencing. Twenty-one (65.6%) patients were infected by genotype B and, 11 (34.4%) by genotype C. G1896A was predominant in genotype B infected patients (95.2% vs 63.6%, P = 0.037). At the end of treatment, 31 (96.8%) and 14 (43.8%) patients achieved biochemical and virological responses, respectively. The biochemical and virological response rates were 40.6 and 0% at 12 months after treatment. Eighteen (56.3%) patients had biochemical relapse within 12 months after withdrawal of lamivudine. By multivariate analysis, the pretreatment serum level of HBV DNA ≥12 Meq/mL was the only factor associated with early biochemical relapse (Odds ratio = 9.333, 95% CI = 1.497 ∼ 58.197, P = 0.017). In conclusion, the virological effect of lamivudine for HBeAg-negative CHB is transient. Most patients had biochemical relapse within 12 months after lamivudine treatment regardless of HBV genotype. A high pretreatment viral load is the determinant for early biochemical relapse.

Original languageEnglish
Pages (from-to)277-284
Number of pages8
JournalJournal of Viral Hepatitis
Volume10
Issue number4
DOIs
Publication statusPublished - 2003 Jul 1

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Lamivudine
Hepatitis B e Antigens
Chronic Hepatitis B
Taiwan
Recurrence
Genotype
Hepatitis B virus
Therapeutics
Polymerase Chain Reaction
Viral Load
Restriction Fragment Length Polymorphisms
Multivariate Analysis
Odds Ratio
Mutation
DNA

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases
  • Virology

Cite this

Huang, Y. H. ; Wu, Jaw Ching ; Chang, Ting-Tsung ; Sheen, I. J. ; Lee, P. C. ; Huo, T. I. ; Su, C. W. ; Wang, Y. J. ; Chang, F. Y. ; Lee, S. D. / Analysis of clinical, biochemical and viral factors associated with early relapse after lamivudine treatment for hepatitis B e antigen-negative chronic hepatitis B patients in Taiwan. In: Journal of Viral Hepatitis. 2003 ; Vol. 10, No. 4. pp. 277-284.
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title = "Analysis of clinical, biochemical and viral factors associated with early relapse after lamivudine treatment for hepatitis B e antigen-negative chronic hepatitis B patients in Taiwan",
abstract = "The efficacy of lamivudine for HBeAg-negative chronic hepatitis B (CHB) Chinese patients has not been fully investigated. The role of the Hepatitis B virus (HBV) genotype on the treatment effect of lamivudine is controversial. Thirty-two consecutive patients with HBeAg-negative CHB were enrolled. All patients were treated with lamivudine 100 mg once daily of 7-12 months duration. The mean total period of follow-up since entry for all patients was 24 ± 3.5 months. HBV genotypes were classified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and verified by sequencing. Precore (G1896A) and basic core promoter (BCP, A1762T & G1764A) mutations were determined by PCR and direct sequencing. Twenty-one (65.6{\%}) patients were infected by genotype B and, 11 (34.4{\%}) by genotype C. G1896A was predominant in genotype B infected patients (95.2{\%} vs 63.6{\%}, P = 0.037). At the end of treatment, 31 (96.8{\%}) and 14 (43.8{\%}) patients achieved biochemical and virological responses, respectively. The biochemical and virological response rates were 40.6 and 0{\%} at 12 months after treatment. Eighteen (56.3{\%}) patients had biochemical relapse within 12 months after withdrawal of lamivudine. By multivariate analysis, the pretreatment serum level of HBV DNA ≥12 Meq/mL was the only factor associated with early biochemical relapse (Odds ratio = 9.333, 95{\%} CI = 1.497 ∼ 58.197, P = 0.017). In conclusion, the virological effect of lamivudine for HBeAg-negative CHB is transient. Most patients had biochemical relapse within 12 months after lamivudine treatment regardless of HBV genotype. A high pretreatment viral load is the determinant for early biochemical relapse.",
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Analysis of clinical, biochemical and viral factors associated with early relapse after lamivudine treatment for hepatitis B e antigen-negative chronic hepatitis B patients in Taiwan. / Huang, Y. H.; Wu, Jaw Ching; Chang, Ting-Tsung; Sheen, I. J.; Lee, P. C.; Huo, T. I.; Su, C. W.; Wang, Y. J.; Chang, F. Y.; Lee, S. D.

In: Journal of Viral Hepatitis, Vol. 10, No. 4, 01.07.2003, p. 277-284.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Analysis of clinical, biochemical and viral factors associated with early relapse after lamivudine treatment for hepatitis B e antigen-negative chronic hepatitis B patients in Taiwan

AU - Huang, Y. H.

AU - Wu, Jaw Ching

AU - Chang, Ting-Tsung

AU - Sheen, I. J.

AU - Lee, P. C.

AU - Huo, T. I.

AU - Su, C. W.

AU - Wang, Y. J.

AU - Chang, F. Y.

AU - Lee, S. D.

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N2 - The efficacy of lamivudine for HBeAg-negative chronic hepatitis B (CHB) Chinese patients has not been fully investigated. The role of the Hepatitis B virus (HBV) genotype on the treatment effect of lamivudine is controversial. Thirty-two consecutive patients with HBeAg-negative CHB were enrolled. All patients were treated with lamivudine 100 mg once daily of 7-12 months duration. The mean total period of follow-up since entry for all patients was 24 ± 3.5 months. HBV genotypes were classified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and verified by sequencing. Precore (G1896A) and basic core promoter (BCP, A1762T & G1764A) mutations were determined by PCR and direct sequencing. Twenty-one (65.6%) patients were infected by genotype B and, 11 (34.4%) by genotype C. G1896A was predominant in genotype B infected patients (95.2% vs 63.6%, P = 0.037). At the end of treatment, 31 (96.8%) and 14 (43.8%) patients achieved biochemical and virological responses, respectively. The biochemical and virological response rates were 40.6 and 0% at 12 months after treatment. Eighteen (56.3%) patients had biochemical relapse within 12 months after withdrawal of lamivudine. By multivariate analysis, the pretreatment serum level of HBV DNA ≥12 Meq/mL was the only factor associated with early biochemical relapse (Odds ratio = 9.333, 95% CI = 1.497 ∼ 58.197, P = 0.017). In conclusion, the virological effect of lamivudine for HBeAg-negative CHB is transient. Most patients had biochemical relapse within 12 months after lamivudine treatment regardless of HBV genotype. A high pretreatment viral load is the determinant for early biochemical relapse.

AB - The efficacy of lamivudine for HBeAg-negative chronic hepatitis B (CHB) Chinese patients has not been fully investigated. The role of the Hepatitis B virus (HBV) genotype on the treatment effect of lamivudine is controversial. Thirty-two consecutive patients with HBeAg-negative CHB were enrolled. All patients were treated with lamivudine 100 mg once daily of 7-12 months duration. The mean total period of follow-up since entry for all patients was 24 ± 3.5 months. HBV genotypes were classified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and verified by sequencing. Precore (G1896A) and basic core promoter (BCP, A1762T & G1764A) mutations were determined by PCR and direct sequencing. Twenty-one (65.6%) patients were infected by genotype B and, 11 (34.4%) by genotype C. G1896A was predominant in genotype B infected patients (95.2% vs 63.6%, P = 0.037). At the end of treatment, 31 (96.8%) and 14 (43.8%) patients achieved biochemical and virological responses, respectively. The biochemical and virological response rates were 40.6 and 0% at 12 months after treatment. Eighteen (56.3%) patients had biochemical relapse within 12 months after withdrawal of lamivudine. By multivariate analysis, the pretreatment serum level of HBV DNA ≥12 Meq/mL was the only factor associated with early biochemical relapse (Odds ratio = 9.333, 95% CI = 1.497 ∼ 58.197, P = 0.017). In conclusion, the virological effect of lamivudine for HBeAg-negative CHB is transient. Most patients had biochemical relapse within 12 months after lamivudine treatment regardless of HBV genotype. A high pretreatment viral load is the determinant for early biochemical relapse.

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