HEPATOLOGY: Factors related to post-treatment relapse in chronic hepatitis B patients who lost HBeAg after lamivudine therapy

• Published in: Journal of gastroenterology and hepatology 2005-12, Vol.20 (12), p.1838-1842
• Main Authors: Byun, Kwan Soo, Kwon, OH Sang, Kim, JU Hyun, Yim, Hyung Joon, Chang, Yun Jung, Kim, Jin Yong, Yeon, Jong Eun, Park, Jong Jae, Kim, Jae Seon, Bak, Young Tae, Lee, Chang Hong
• Format: Article
• Language: English
• Subjects: Hepatitis B virus
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2005.03952.x

Background and Aim:It is uncertain if a patient's lamivudine response after HBeAg loss is durable. In Korean chronic hepatitis B patients, the relapse rate is high after termination of lamivudine therapy for patients with HBeAg loss. We evaluated the factors related to relapse in chronic hepatitis B patients with HBeAg loss after lamivudine therapy. Methods:A total of 132 chronic hepatitis B patients, who initially had HBeAg and did not have decompensated features, were analyzed in this study. These patients lost the HBeAg after lamivudine therapy and then their therapy was stopped. Post-treatment serum alanine aminotransferase (ALT), HBeAg, anti-HBe and hepatitis B virus (HBV) DNA were monitored until relapse. Results:Seventy-five patients relapsed (cumulative relapse rate: 56% at 6 months). Upon univariate analysis, the factors of age, serum total bilirubin, presence of anti-HBe after HBeAg loss, and the duration of additional lamivudine therapy after HBeAg loss were associated with relapse. Upon multivariate analysis, older age, a higher serum total bilirubin and the shorter duration of additional lamivudine therapy were significant risk factors for relapse. Patterns of relapse were the re-elevation of ALT, re-emergence of HBV DNA (69 patients) and reappearance of HBeAg (55 patients). Conclusions:To prevent relapse in patients with chronic hepatitis B infection after lamivudine therapy, age and serum bilirubin level of patients as well as a prolonged duration of additional lamivudine therapy should be considered.