Clinical observation of chronic hepatitis B patients in the treatment of lamivudine for three years

Objective To evaluate the relationships of indicators between HBeAg-positive and HBeAg-negative chronic hepatitis B(CHB)patients in the treatment of lamivudine for the long-term.Methods Sixty-three patients with chronic hepatitis B from January 2006 to January 2009 were studied.The patients were divided into two groups,one with HBeAg-positive(30 cases)and the other with HBeAg-negative(33 cases).All patients were treated with lamivudine(100 mg/d)then were observed for three years.The serum HBV markers,HBV DNA,ALT,AFP and other biochemical indicators were detected and the measurement data were compared between the two groups by chi square test.Results All the 63 patients with chronic hepatitis B,30(47.6%)patients were HBeAg-positive and the remaining 33(52.4%)were HBeAg-negative.There were no significant difference of the ALT,HBV DNA,the incidence of hepatocellular carcinoma and the ratio of HBsAg-negative conversion between HBeAg-positive and HBeAg-negative groups in the treatment of lamivudine,However,between the two groups the ratio of YMDD mutation and the incidence of liver cirrhosis showed statistical significance(P0.05).The ratio of YMDD mutation of HBeAg-positive patients was 43.3%,which was significantly higher than that in HBeAg-negative(18.2%)(χ2=4.720,P0.05);the proportion of patients with liver cirrhosis in HBeAg-negative group(37.0%)was higher than that in HBeAg-positive group(5.9%)(χ2=3.866,P0.05).Conclusions CHB patients with HBeAg-positive is more susceptible to YMDD mutation than HBeAg-negative patients but less susceptible to liver cirrhosis.