Efficacy of Lamivudine Treatment in Thai Chronic Hepatitis B Patients

Background: Lamivudine is an effective agent for chronic hepatitis B (CHB). One year lamivudine treatment significantly suppresses hepatitis B viral replication, improves hepatic necroinflammatory activity and prevents progression of fibrosis. However, there are limited data on the extended lamivudine treatment for CHB patients in Thailand. Objective: To evaluated therapeutic efficacy of lamivudine and determined factors that related to complete response at 12 months. Patients and Methods: Retrospectively, we collected data of CHB patients treated with lamivudine and followed in Hepatitis Clinic, Siriraj Hospital during 1998-2002. Overall, there were 93 patients included in the study. All received lamivudine 100 mg once daily for at least 6 months to 2 years. We defined the responses to treatment into biochemical, serological, virological and complete response. Results: Of 93 patients, 75 were men and 18 were female. Fifty-two cases (55.9%) were HBeAg positive. Mean age was 45.7 (17-68) years. All patients continued lamivudine with safety. Biochemical response among HBeAg positive patients was not significantly different from those with HBeAg negative at 6, 12, 18 ,24 months. In HBeAg positive group, HBeAg seroconversion was 36.4% and 41.7% and complete response was 42.4% and 30% at 12 and 24 months, respectively. More than 90% of HBeAg negative patients had virological response with 63.6% and 50% had complete response at 12 and 24 months, respectively. No significant predictive factor for complete response at 12 months was found in both HBeAg positive and negative groups. Thirteen patients (14%) had flare ALT during lamivudine treatment but most of then had normalization of ALT after continue lamivudine treatment. Conclusion: Lamivudine treatment in Thai CHB patients is effective in terms of biochemical, virological, serological and complete response in both HBeAg positive and HBeAg negative patients.