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Article: The duration of lamivudine therapy for chronic hepatitis b: Cessation vs. continuation of treatment after HBeAg seroconversion

TitleThe duration of lamivudine therapy for chronic hepatitis b: Cessation vs. continuation of treatment after HBeAg seroconversion
Authors
Issue Date2009
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
Citation
American Journal Of Gastroenterology, 2009, v. 104 n. 8, p. 1940-1946 How to Cite?
AbstractOBJECTIVES: The aim of this study was to compare the virological and biochemical relapse rates in Asian chronic hepatitis B patients with lamivudine-induced hepatitis B e antigen (HBeAg) seroconversion, between those who stopped therapy after HBeAg seroconversion and those who continued to receive lamivudine.METHODS:All patients with lamivudine-induced HBeAg seroconversion were included. Patients who stopped lamivudine after HBeAg seroconversion (n22) were compared with 79 patients who continued to receive lamivudine (n79). Demographic, virological, and biochemical parameters were recorded at baseline, and throughout the duration of follow-up.RESULTS:In patients who stopped lamivudine, the median follow-up after stopping lamivudine was 20 months. Of these patients, 14 (64%) had virological rebound, with a cumulative incidence of 82% at 4 years. There was no significant difference in number of flares between patients with normal alanine aminotransferase (ALT) and undetectable hepatitis B virus (HBV) DNA at the time of stopping lamivudine compared with that in patients with either abnormal ALT, detectable HBV DNA, or both (P0.73). The cumulative incidence of HBeAg seroreversion and ALT flares at 5 years after stopping lamivudine was 9 and 44%, respectively. Of the 79 patients who continued with lamivudine, 62 (78%) had undetectable HBV DNA at the time of last follow-up, whereas no patients had undetectable HBV DNA after stopping lamivudine (P<0.001). The cumulative incidence of ALT flares at 5 years was 16% (P<0.001 compared with those who stopped taking lamivudine). After a median treatment duration of 79 months, lamivudine-resistant mutations occurred in eight patients (10%).CONCLUSIONS:In Asian HBeAg-positive patients, continuing with lamivudine after achieving HBeAg seroconversion was associated with a higher proportion of undetectable HBV DNA and a lower number of ALT flares, when compared with those with cessation of lamivudine. In patients who achieved HBeAg seroconversion with lamivudine, the resistance rate was not high when treatment was continued after HBeAg seroconversion. © 2009 by the American College of Gastroenterology.
Persistent Identifierhttp://hdl.handle.net/10722/163262
ISSN
2014 Impact Factor: 10.755
2014 SCImago Journal Rankings: 3.376
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFung, Jen_US
dc.contributor.authorLai, CLen_US
dc.contributor.authorTanaka, Yen_US
dc.contributor.authorMizokami, Men_US
dc.contributor.authorYuen, Jen_US
dc.contributor.authorWong, DKHen_US
dc.contributor.authorYuen, MFen_US
dc.date.accessioned2012-09-05T05:29:17Z-
dc.date.available2012-09-05T05:29:17Z-
dc.date.issued2009en_US
dc.identifier.citationAmerican Journal Of Gastroenterology, 2009, v. 104 n. 8, p. 1940-1946en_US
dc.identifier.issn0002-9270en_US
dc.identifier.urihttp://hdl.handle.net/10722/163262-
dc.description.abstractOBJECTIVES: The aim of this study was to compare the virological and biochemical relapse rates in Asian chronic hepatitis B patients with lamivudine-induced hepatitis B e antigen (HBeAg) seroconversion, between those who stopped therapy after HBeAg seroconversion and those who continued to receive lamivudine.METHODS:All patients with lamivudine-induced HBeAg seroconversion were included. Patients who stopped lamivudine after HBeAg seroconversion (n22) were compared with 79 patients who continued to receive lamivudine (n79). Demographic, virological, and biochemical parameters were recorded at baseline, and throughout the duration of follow-up.RESULTS:In patients who stopped lamivudine, the median follow-up after stopping lamivudine was 20 months. Of these patients, 14 (64%) had virological rebound, with a cumulative incidence of 82% at 4 years. There was no significant difference in number of flares between patients with normal alanine aminotransferase (ALT) and undetectable hepatitis B virus (HBV) DNA at the time of stopping lamivudine compared with that in patients with either abnormal ALT, detectable HBV DNA, or both (P0.73). The cumulative incidence of HBeAg seroreversion and ALT flares at 5 years after stopping lamivudine was 9 and 44%, respectively. Of the 79 patients who continued with lamivudine, 62 (78%) had undetectable HBV DNA at the time of last follow-up, whereas no patients had undetectable HBV DNA after stopping lamivudine (P<0.001). The cumulative incidence of ALT flares at 5 years was 16% (P<0.001 compared with those who stopped taking lamivudine). After a median treatment duration of 79 months, lamivudine-resistant mutations occurred in eight patients (10%).CONCLUSIONS:In Asian HBeAg-positive patients, continuing with lamivudine after achieving HBeAg seroconversion was associated with a higher proportion of undetectable HBV DNA and a lower number of ALT flares, when compared with those with cessation of lamivudine. In patients who achieved HBeAg seroconversion with lamivudine, the resistance rate was not high when treatment was continued after HBeAg seroconversion. © 2009 by the American College of Gastroenterology.en_US
dc.languageengen_US
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.htmlen_US
dc.relation.ispartofAmerican Journal of Gastroenterologyen_US
dc.subject.meshAdulten_US
dc.subject.meshChinaen_US
dc.subject.meshFemaleen_US
dc.subject.meshHepatitis B E Antigens - Blooden_US
dc.subject.meshHepatitis B, Chronic - Blood - Drug Therapy - Immunologyen_US
dc.subject.meshHumansen_US
dc.subject.meshLamivudine - Administration & Dosageen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshReverse Transcriptase Inhibitors - Administration & Dosageen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshYoung Adulten_US
dc.titleThe duration of lamivudine therapy for chronic hepatitis b: Cessation vs. continuation of treatment after HBeAg seroconversionen_US
dc.typeArticleen_US
dc.identifier.emailFung, J:jfung@sicklehut.comen_US
dc.identifier.emailLai, CL:hrmelcl@hku.hken_US
dc.identifier.emailWong, DKH:danywong@hku.hken_US
dc.identifier.emailYuen, MF:mfyuen@hkucc.hku.hken_US
dc.identifier.authorityFung, J=rp00518en_US
dc.identifier.authorityLai, CL=rp00314en_US
dc.identifier.authorityWong, DKH=rp00492en_US
dc.identifier.authorityYuen, MF=rp00479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1038/ajg.2009.200en_US
dc.identifier.pmid19455108-
dc.identifier.scopuseid_2-s2.0-68349128691en_US
dc.identifier.hkuros158445-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-68349128691&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume104en_US
dc.identifier.issue8en_US
dc.identifier.spage1940en_US
dc.identifier.epage1946en_US
dc.identifier.isiWOS:000268965300008-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridFung, J=23091109300en_US
dc.identifier.scopusauthoridLai, CL=7403086396en_US
dc.identifier.scopusauthoridTanaka, Y=7405315865en_US
dc.identifier.scopusauthoridMizokami, M=7103318255en_US
dc.identifier.scopusauthoridYuen, J=7102620480en_US
dc.identifier.scopusauthoridWong, DKH=7401535819en_US
dc.identifier.scopusauthoridYuen, MF=7102031955en_US

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