Clinical Course of Lamivudine Monotherapy in Patients with Decompensated Cirrhosis due to HBeAg negative chronic HBV infection

We have evaluated the efficacy of long-term lamivudine monotherapy in patients with decompensated HBeAg-negative/HBV-DNA positive cirrhosis. We analyzed the clinical course and outcome of lamivudine treatment in 30 consecutive cirrhotics and compared with 30 HBV untreated historical HBeAg-negative c...

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Published in:	The American journal of gastroenterology Vol. 99; no. 1; pp. 57 - 63
Main Authors:	MANOLAKOPOULOS, Spilios, KARATAPANIS, Stylianos, AVGERINOS, Alec, ELEFSINIOTIS, Jiannis, MATHOU, Nicoletta, VLACHOGIANNAKOS, Jiannis, ILIADOU, Elissabet, KOUGIOUMTZAN, Anastasios, ECONOMOU, Michalis, TRIANTOS, Christos, TZOURMAKLIOTIS, Dimitrios
Format:	Journal Article
Language:	English
Published:	Oxford Blackwell Publishing 01-01-2004 Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
Subjects:	Adult Aged Aged, 80 and over Antiviral Agents - therapeutic use Biological and medical sciences Female Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen Hepatitis B e Antigens - analysis Hepatitis B virus Hepatitis B, Chronic - complications Hepatitis B, Chronic - drug therapy Human viral diseases Humans Infectious diseases Lamivudine - therapeutic use Liver - physiopathology Liver Cirrhosis - drug therapy Liver Cirrhosis - mortality Liver Cirrhosis - physiopathology Liver Cirrhosis - virology Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Other diseases. Semiology Reverse Transcriptase Inhibitors - therapeutic use Survival Rate Treatment Outcome Viral diseases Viral hepatitis Human RNA-directed DNA polymerase Enzyme Transferases Enzyme inhibitor Hepatic disease Lamivudine Infection Viral hepatitis B Cirrhosis Nucleotidyltransferases Chronic Viral disease Dideoxynucleoside Reverse transcriptase inhibitor Gastroenterology Digestive diseases Nucleosidic analog Pyrimidine nucleoside
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Summary:	We have evaluated the efficacy of long-term lamivudine monotherapy in patients with decompensated HBeAg-negative/HBV-DNA positive cirrhosis. We analyzed the clinical course and outcome of lamivudine treatment in 30 consecutive cirrhotics and compared with 30 HBV untreated historical HBeAg-negative controls matched for age and gender. Significant clinical improvement, defined as a reduction of at least two points in Child-Pugh score was observed in 23 of the 30 treated patients (76.6%) versus none of the 30 patients in the control group (p < 0.0001) after a mean follow-up of 20.6 +/- 12.1(+/-SD) months. There were 10 deaths in the treated group versus 24 in the control group (p= 0.07). Liver-related deaths occurred in five of the eight patients soon after the development of biochemical breakthrough. Patients with clinical improvement had better survival than patients with no improvement (p= 0.04) or those who developed biochemical breakthrough due to YMDD mutants (p= 0.001). Lamivudine significantly improves liver function in HBeAg-negative decompensated cirrhosis. However, the development of the biochemical breakthrough due to YMDD mutants is associated with fatal outcome.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0002-9270 1572-0241
DOI:	10.1046/j.1572-0241.2003.04021.x