Preliminary trial of lamivudine therapy for chronic HBV infection

Objective To evaluate the effect of lamivudine therapy on chronic HBV Infection in different clinical types. Methods 68 hospitalized patients with chronic HBV infection and positive for HBV DNA (PCR) in serum were enrolled to receive lamivudine 150mg orally, once daily for six months. Efficacy was assessed by clinical, biochemical, serologic and virologic improvements. Results Lamivudine was safe and well tolerated. Serum HBV DNA fell rapidly to undetectable level in all P8tients but one. (1)In chronic hepatitis B group, 40 cases treated with lamivudine and 40 controlled cases were all resolved aradually from their disease progression. In contrast with lamivudine recipients, HBV viremia still maintained and 11 patients (27.5%) relapsed during 3-6 month follow-up period in the controlled cases (p0.001).Among lamivudine recipients, there were 20 patients treated simultaneously in combination with alpha interferon 3MU-5MU, intramuscularly tiw for 24 weeks. But by the end of treatment, there was no significant difterence in all resects between lamivudine monotherapy and lamivudine Plus alpha niterteron. (2) The condition of 18 patients with decompensated cirrhosis was tending to be stable, along with liver function improving and Child-Pugh score decreasing. (3) Eight of 10 patients with chronic severe hepatitis had a slow but marked clinical and biochemical improvement in liver function and quality of life. The remaning 2 patients with complications of alcoholic cirrhosis or severe diabetes died of progressing hepatic failure within 3 months of treatment initiation. Conclusion Preliminary data indicate that lamivudine therapy can effectively inhibit HBV replication and significantly improve liver function either in chronic hepatitis B or in those with decompensated cirrhosis or chronic severe hepatitis.[