Lamivudine in chronic hepatitis B virus

OBJECTIVE: To access the effect of one year treatment with Lamivudine, and its durability on patients with compensated chronic hepatitis B.

METHODS: Thirty-six patients with hepatitis B surface antigen positive, hepatitis B virus deoxyribonucleic acid (DNA) positive, were treated with 100 mg Lamivudine daily for one year, irrespective of their liver enzymes level, alanine aminotransferase or hepatitis B envelope antigen status. Patients with normal alanine aminotransferase and negative hepatitis B virus DNA at the end of the treatment were responders and those with persistent response 16 weeks off treatment were considered having durable response.

RESULTS: Three patients dropped out and 33 patients completed the study. Eight patients (24.2%) had normal alanine aminotransferase, 25 patients (75.8%) had increased alanine aminotransferase. Thirty patients (90.9%) were hepatitis B envelope antigen negative. Two patients (25%) with initial normal alanine aminotransferase and 7 patients (28%) with increased enzyme level, responded at end of treatment. One patient with positive hepatitis B envelope antigen responded to treatment. Only one patient relapsed during follow-up period off treatment.

CONCLUSION: Lamivudine is associated with durable response in patients with hepatitis B virus and negative hepatitis B envelope antigen. Longer treatment for more than one year may be required to improve response rates.