[Predictive factors and efficacy of lamivudine treatment in chronic hepatitis B infection].

BACKGROUND/AIMS: Lamivudine, an oral nucleoside analogue, effectively suppresses hepatitis B virus (HBV) replications and improves liver enzymes as well as liver histology. The aim of this study was to evaluate the effectiveness of lamivudine and the patient-dependent or laboratory variables that predict HBeAg seroconversion. METHODS: We retrospectively analyzed 519 consecutive patients with HBeAg-positive chronic hepatitis B who were treated with lamivudine. The duration of lamivudine therapy was from 6 to 64 months (mean 20 months). RESULTS: The HBeAg seroconversion was achieved in 192 patients (37%). The cumulative HBeAg seroconversion rates were 28% at 12 months, 39% at 24 months, 49% at 36 months, and 53% at 48 months. The predictive factors of lamivudine-induced HBeAg seroconvresion were the changing patterns of quantitative HBeAg level during lamivudine therapy, pretreatment quantitative HBeAg levels, ALT levels, and the duration of lamivudine therapy. One hundred eighty-three patients who had achieved HBeAg seroconversion showed patterns that HBeAg levels were continuously decreased. Therapy was discontinued after HBeAg seroconversion in 121 patients. Sixty-six patients experienced a relapse during the follow-up period (mean 8.9 months). CONCLUSIONS: The continuously decreasing patterns of quantitative HBeAg levels during lamivudine therapy can predict HBeAg seroconversion in clinical settings.