Clinical outcome of long term Lamivudine therapy in patients with chronic HBV infection

Objective To evaluate the optimum treatment outcome in chronic HBV patients treated with Lamivudine.Meth-ods A total of 216,114 chronic hepatitis B and 94 cirrhotic,patients were included in the study.The patients were divid-ed into HBeAg positive group(122 patients) and HBeAg negative group(94 patients).All patients were treated with Lamivudine 100mg once daily for 36-84 months(61 ± 9.8 months on average).Liver function tests,HBVDNA level,HBeAg sero conversion,serological markers and genetic variations were analyzed.Results No viral breakthrough and viral mutation was seen within 5 years among patients who had undetectable HBVDNA at the second week of treatment.The HBeAg serum conversion rate of was 62.5% in both groups during the 5 years of treatment.HBVDNA level was undetect-able after 3-4 weeks of treatment.The rate of viral breakthrough was 9.1% and the rate of HBeAg serum conversion was 45.5% in HBeAg positive group,and there was no viral breakthrough in HBeAg negative group.The virologic response and the viral breakthrough in both groups at 5-8weeks,9-12 weeks,and 13-24 weeks were 52.4% vs 41.2%,71.4% vs 66.7%,and 100% vs 100%,respectively during the 5 years of treatment.(P 0.05) Conclusion A 4 week virologic response might be used to predict drug resistance and the long term effect of Lamivudine therapy in patients with chronic hepatitis B infection.It could also be used for choosing the appropriate patients to be treated with lamivudine effectively.