Re‐treatment of patients with anti‐HBe‐positive chronic hepatitis B who relapsed after an initial course of lamivudine

• Published in: Alimentary pharmacology & therapeutics 2003-11, Vol.18 (9), p.933-940
• Main Authors: Niro, G. A., Santantonio, T., Fontana, R., Insalata, M., Facciorusso, D., Signorile, F., Perri, F., Guastadisegni, A., Gioffreda, D., Palmieri, O., Pastore, G., Andriulli, A.
• Format: Article
• Language: English
• Subjects: Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - therapeutic use; Biological and medical sciences; DNA, Viral - metabolism; Drug Evaluation; Drug Resistance, Viral; Female; Follow-Up Studies; Hepatitis B e Antigens; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - genetics; Hepatitis B, Chronic - immunology; Humans; Lamivudine - therapeutic use; Male; Medical sciences; Pharmacology. Drug treatments; Recurrence; Retreatment; Reverse Transcriptase Inhibitors - therapeutic use
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1046/j.1365-2036.2003.01787.x

Summary Aim : To evaluate the efficacy of a long‐term course of lamivudine monotherapy in patients with anti‐HBe‐positive chronic hepatitis B who relapsed after the first course of either lamivudine/interferon (n = 16; Group 1) or lamivudine (n = 20; Group 2). Methods : Biochemical and virological tests were performed every 3 months. At baseline and breakthrough, the region coding for the YMDD amino acid motif was sequenced. Results : The length of re‐treatment averaged 24 months. The virological response peaked at 6 months (94.4%), and declined to 66.7% and 50% at 12 and 24 months, respectively. The rates of breakthrough were 2.9%, 31.4% and 48.6% at 6, 12 and 24 months, respectively. By the second year, responders amounted to 62.5% and 40% in Groups 1 and 2, respectively (P = 0.10). The 18 responders at month 24 are still on therapy after 25–51 months of treatment: 14 still maintain a response, nine from Group 1 and five from Group 2. Conclusions : Re‐treatment with lamivudine can control viral replication. This effect is maintained for the initial 12 months in two‐thirds of patients, but afterwards the duration of response lessens due to the development of viral resistance.