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Article: Long-term lamivudine therapy reduces the risk of long-term complications of chronic hepatitis B infection even in patients without advanced disease

TitleLong-term lamivudine therapy reduces the risk of long-term complications of chronic hepatitis B infection even in patients without advanced disease
Authors
Issue Date2007
PublisherInternational Medical Press. The Journal's web site is located at http://www.intmedpress.com/Journals/AVT/journals_avt_home.cfm
Citation
Antiviral Therapy, 2007, v. 12 n. 8, p. 1295-1303 How to Cite?
AbstractBackground: Long-term effects of lamivudine treatment on chronic hepatitis B patients without advanced disease remain unknown. Our aim was to investigate the effects of long-term lamivudine treatment and lamivudine-resistant virus (YMDD) on the development of cirrhosis and hepatocellular carcinoma (HCC) in asymptomatic patients without advanced disease. Methods: One hundred and forty-two hepatitis B e antigen (HBeAg)-positive patients (median age: 33.9 years) on long-term lamivudine (median treatment duration: 89.9 months) and 124 HBeAg-positive controls (median age: 33.4 years) were prospectively followed up. Patients were monitored for the development of cirrhosis and HCC, liver biochemistry, hepatitis B virus (HBV) DNA levels, HBeAg seroconversion and hepatitis flares. YMDD mutations (YMDD-MT) were determined annually. Results: Lamivudine-treated patients had a significantly lower cumulative rate of development of cirrhosis and/or HCC compared with controls (P=0.005). YMDD-MT occurred in 76.3% of patients after 8 years of lamivudine treatment. When compared with controls and patients with YMDD-MT, patients without YMDD-MT had the greatest reduction of HBV DNA and bilirubin levels, slowest decline of albumin level, highest rate of HBeAg seroconversion and lowest risk of hepatitis flare. Patients with YMDD-MT still had a lower risk for developing cirrhosis and/or HCC (P=0.024) and a greater HBV DNA reduction (P=0.001) in comparison with controls. Patients with YMDD-MT and controls had a similar chance of hepatitis flares and hepatic decompensation. Conclusions: Long-term lamivudine treatment was associated with a reduced chance of developing cirrhosis and HCC in patients without advanced disease. Although YMDD-MT reduced the benefits from lamivudine therapy, the outcome of these patients was still better than untreated patients. © 2007 International Medical Press.
Persistent Identifierhttp://hdl.handle.net/10722/77758
ISSN
2015 Impact Factor: 2.916
2015 SCImago Journal Rankings: 1.361
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, MFen_HK
dc.contributor.authorSeto, WKen_HK
dc.contributor.authorChow, DHFen_HK
dc.contributor.authorTsui, Ken_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorNgai, VWSen_HK
dc.contributor.authorWong, BCYen_HK
dc.contributor.authorFung, Jen_HK
dc.contributor.authorYuen, JCHen_HK
dc.contributor.authorLai, CLen_HK
dc.date.accessioned2010-09-06T07:35:24Z-
dc.date.available2010-09-06T07:35:24Z-
dc.date.issued2007en_HK
dc.identifier.citationAntiviral Therapy, 2007, v. 12 n. 8, p. 1295-1303en_HK
dc.identifier.issn1359-6535en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77758-
dc.description.abstractBackground: Long-term effects of lamivudine treatment on chronic hepatitis B patients without advanced disease remain unknown. Our aim was to investigate the effects of long-term lamivudine treatment and lamivudine-resistant virus (YMDD) on the development of cirrhosis and hepatocellular carcinoma (HCC) in asymptomatic patients without advanced disease. Methods: One hundred and forty-two hepatitis B e antigen (HBeAg)-positive patients (median age: 33.9 years) on long-term lamivudine (median treatment duration: 89.9 months) and 124 HBeAg-positive controls (median age: 33.4 years) were prospectively followed up. Patients were monitored for the development of cirrhosis and HCC, liver biochemistry, hepatitis B virus (HBV) DNA levels, HBeAg seroconversion and hepatitis flares. YMDD mutations (YMDD-MT) were determined annually. Results: Lamivudine-treated patients had a significantly lower cumulative rate of development of cirrhosis and/or HCC compared with controls (P=0.005). YMDD-MT occurred in 76.3% of patients after 8 years of lamivudine treatment. When compared with controls and patients with YMDD-MT, patients without YMDD-MT had the greatest reduction of HBV DNA and bilirubin levels, slowest decline of albumin level, highest rate of HBeAg seroconversion and lowest risk of hepatitis flare. Patients with YMDD-MT still had a lower risk for developing cirrhosis and/or HCC (P=0.024) and a greater HBV DNA reduction (P=0.001) in comparison with controls. Patients with YMDD-MT and controls had a similar chance of hepatitis flares and hepatic decompensation. Conclusions: Long-term lamivudine treatment was associated with a reduced chance of developing cirrhosis and HCC in patients without advanced disease. Although YMDD-MT reduced the benefits from lamivudine therapy, the outcome of these patients was still better than untreated patients. © 2007 International Medical Press.en_HK
dc.languageengen_HK
dc.publisherInternational Medical Press. The Journal's web site is located at http://www.intmedpress.com/Journals/AVT/journals_avt_home.cfmen_HK
dc.relation.ispartofAntiviral Therapyen_HK
dc.subject.meshAdulten_HK
dc.subject.meshCarcinoma, Hepatocellular - etiologyen_HK
dc.subject.meshDisease Progressionen_HK
dc.subject.meshDrug Resistance, Viralen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHepatitis B virus - drug effectsen_HK
dc.subject.meshHepatitis B, Chronic - complications - drug therapyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLamivudine - pharmacology - therapeutic useen_HK
dc.subject.meshLiver Cirrhosis - etiologyen_HK
dc.subject.meshLiver Neoplasms - etiologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshReverse Transcriptase Inhibitors - therapeutic useen_HK
dc.subject.meshTime Factorsen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleLong-term lamivudine therapy reduces the risk of long-term complications of chronic hepatitis B infection even in patients without advanced diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1359-6535&volume=12&spage=1295&epage=1303&date=2007&atitle=Long-term+lamivudine+therapy+reduces+the+risk+of+long-term+complications+of+chronic+hepatitis+B+infection+even+in+patients+without+advanced+diseaseen_HK
dc.identifier.emailYuen, MF: mfyuen@hku.hken_HK
dc.identifier.emailSeto, WK: wkseto2@hku.hken_HK
dc.identifier.emailWong, DKH: danywong@hku.hken_HK
dc.identifier.emailWong, BCY: bcywong@hku.hken_HK
dc.identifier.emailFung, J: jfung@sicklehut.comen_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.identifier.authoritySeto, WK=rp01659en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid18240869-
dc.identifier.scopuseid_2-s2.0-38049087457en_HK
dc.identifier.hkuros144475en_HK
dc.identifier.hkuros213667-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-38049087457&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume12en_HK
dc.identifier.issue8en_HK
dc.identifier.spage1295en_HK
dc.identifier.epage1303en_HK
dc.identifier.isiWOS:000252068600015-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK
dc.identifier.scopusauthoridSeto, WK=23390675900en_HK
dc.identifier.scopusauthoridChow, DHF=35979710900en_HK
dc.identifier.scopusauthoridTsui, K=8239092000en_HK
dc.identifier.scopusauthoridWong, DKH=7401535819en_HK
dc.identifier.scopusauthoridNgai, VWS=15061738300en_HK
dc.identifier.scopusauthoridWong, BCY=7402023340en_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridYuen, JCH=7102620480en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK

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