Viral Hepatitis
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 15, 2004; 10(24): 3574-3578
Published online Dec 15, 2004. doi: 10.3748/wjg.v10.i24.3574
End-of-treatment virologic response does not predict relapse after lamivudine treatment for chronic hepatitis B
Chun-Jen Liu, Wen-Ling Huang, Pei-Jer Chen, Ming-Yang Lai, Jia-Horng Kao, Ding-Shinn Chen
Chun-Jen Liu, Pei-Jer Chen, Ming-Yang Lai, Jia-Horng Kao, Ding-Shinn Chen, Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan, China
Wen-Ling Huang, Pei-Jer Chen, Ming-Yang Lai, Jia-Horng Kao, Ding-Shinn Chen, Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan, China
Jia-Horng Kao, Hepatitis Research Center, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan, China
Pei-Jer Chen, Ming-Yang Lai, Jia-Horng Kao, Department of Medical Research, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by Grants From the Department of Health, the National Science Council, Executive Yuan, Taiwan; National Taiwan University Hospital (93S022); and Liver Disease Prevention and Treatment Research Foundation, Taipei, Taiwan
Correspondence to: Professor Jia-Horng Kao, Director, Hepatitis Research Center, National Taiwan University Hospital, 1 Chang-Te St., Taipei 100, Taiwan, China. kjh@ha.mc.ntu.edu.tw
Telephone: +886-2-23123456 Ext. 7307 Fax: +886-2-23317624
Received: February 6, 2004
Revised: March 17, 2004
Accepted: March 24, 2004
Published online: December 15, 2004
Abstract

AIM: Attaining hepatitis B e antigen (HBeAg) seroconversion during lamivudine treatment is associated with fewer relapses in HBeAg-positive patients. In HBeAg-negative patients, predictors for post-treatment relapse remain largely unknown. We therefore studied whether end-of-treatment virologic response correlated with relapse after lamivudine treatment.

METHODS: We prospectively analyzed 12 HBeAg-negative patients and 14 HBeAg-positive patients with chronic hepatitis B, who received at least 9 mo of lamivudine treatment and were followed up for 12 mo post-treatment. Relapse of hepatitis B activity was defined by an elevation of serum ALT level above twice the upper limit of normal as well as reappearance of serum HBV DNA by the branched DNA assay or HBeAg during the follow-up period. The serum viral loads during and at the end of treatment were further determined by a quantitative real-time polymerase chain reaction assay.

RESULTS: Relapse occurred in 6 (50.0%) HBeAg-negative patients within 12 mo post-treatment. Two relapsers had end-of-treatment serum viral load < 1000 copies/mL, the proportion was not significantly different from that in the 6 non-relapsers (33.3% vs 16.7%; P = 1.00). Hepatitis B virus (HBV) DNA levels did not correlate with post-treatment relapse in HBeAg-positive patients either. However, genotype C patients tended to have a lower relapse rate than genotype B patients (14.3% vs 57.9%, P = 0.08).

CONCLUSION: Our results suggest that end-of-treatment virologic response cannot predict post-treatment relapse in patients with HBeAg-negative or -positive chronic hepatitis B. The impact of HBV genotype on the response to lamivudine treatment awaits further studies.

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