Durability of antiviral response in HBeAg-positive chronic hepatitis B patients who maintained virologic response for one year after lamivudine discontinuation

Dig Dis Sci. 2009 Jul;54(7):1572-7. doi: 10.1007/s10620-008-0508-3. Epub 2008 Oct 31.

Abstract

The purpose of this study is to determine the long-term relapse rate and associated risk factors in HBeAg-positive chronic hepatitis B (CHB) patients who had maintained virologic response (VR) for 1 year after lamivudine (LMV) discontinuation. We enrolled 55 treatment-naive HBeAg-positive CHB patients who achieved and maintained VR until 1 year after LMV discontinuation. Delayed relapse was defined as an elevation of HBV DNA after sustained VR for 1 year. During follow-up, 16 of 55 patients (29%) showed delayed relapse. Beginning 1 year after LMV discontinuation, the cumulative rates of relapse after 2 and 4 years were 29 and 44%, respectively. In multivariate analysis, age (P = 0.029) and >2,000 copies/ml HBV DNA 3 months after LMV discontinuation (P = 0.047) were significant predictors of delayed relapse. Delayed relapse is not infrequent, even in patients who maintain VR for 1 year after LMV discontinuation. Therefore, LMV maintenance therapy might be considered in HBeAg-positive CHB patients who achieve VR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage*
  • DNA, Viral / blood
  • Female
  • Follow-Up Studies
  • Hepatitis B e Antigens / blood
  • Hepatitis B virus / genetics
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / virology*
  • Humans
  • Immunoradiometric Assay
  • Lamivudine / administration & dosage*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Recurrence
  • Remission Induction
  • Retrospective Studies
  • Reverse Transcriptase Inhibitors / administration & dosage*
  • Risk Factors
  • Viral Load*
  • Virus Replication / drug effects

Substances

  • Antiviral Agents
  • DNA, Viral
  • Hepatitis B e Antigens
  • Reverse Transcriptase Inhibitors
  • Lamivudine