Clinical research of treating patients with chronic HBV infection by only using lamivudine

Objective:To study clinical strategies of optimal treatment with lamivudine for patients with chronic HBV infection.Methods: Form Sep 2002 to Aug 2006,108 cases of chronic HBV infection were divided into HBeAg positive group and HBeAg negative group in which all patients were given lamivudine 100mg/d,p.o for long-term treatment and following-up endpoint was in Sep 2009.Results: 108 patients were observed with following-up 37~84 months,averaged(58 ± 13.6) months.In both HBeAg positive group and HBeAg negative group,the incidences of virological breakthrough were related to the decline speed of HBVDNA levels in which the more fastly speed of HBVDNA declined,the lower rate of resistance was.The level of HBVDNA changed negatively at 2 weeks,the rate of virology breakthrough was 0%,the rate of HBeAg serum conversion was 62.5%;HBVDNA level changed negatively at 3~4 weeks,the rate of virological breakthrough was from 0% to 11%,the rate of HBeAg serum conversion was 50%.At 5~8 weeks,9~12weeks and 13~24weeks,the rates of virological breakthrough in the patient of levels of HBVDNA changed negatively were 44%~52.6%,75%~80% and 100%.Conclusion: Virological response at 2-week or 4-week can predict more accurately the occurrence of drug resistance and the risk of long-term effect,which is a great significance to help us select appropriate patients with lamivudine therapy.