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ORIGINAL ARTICLE

Extended lamivudine consolidation therapy in hepatitis B e antigen-positive chronic hepatitis B patients improves sustained hepatitis B e antigen seroconversion

, , , , , , & show all
Pages 75-81 | Received 09 Jul 2009, Accepted 05 Oct 2009, Published online: 24 Dec 2009
 

Abstract

Objectives. Longer lamivudine (LAM) consolidation therapy after hepatitis B e antigen (HBeAg) seroconversion has been demonstrated to reduce the cumulative relapse rate. However, the optimal interval of LAM consolidation therapy remains controversial. We evaluated the post-treatment durability of LAM-induced HBeAg seroconversion and the length of LAM consolidation therapy required to maintain sustained HBeAg seroconversion. Material and methods. This retrospective study included 401 naive HBeAg-positive chronic hepatitis B patients who were treated with LAM 100 mg daily for at least 24 weeks (range 24–258 weeks). Among them, 124 patients who achieved a complete response (HBeAg seroconversion, alanine aminotransferase normalization, hepatitis B virus DNA < 200 copies/ml) at the end of LAM therapy were followed up for at least 48 weeks (range 48–350 weeks). Results. Of the 124 complete responders, 42 (33.87%) achieved a sustained response (persistent response ≥ 48 weeks). However, the cumulative relapse rates at 48 and 96 weeks post-treatment were 54.03% and 68.4%, respectively. Multivariate analysis revealed pretreatment age ≤ 34 years [hazard ratio (HR) 2.25; 95% confidence interval (CI) 1.40–3.62; p < 0.001] and LAM consolidation therapy ≥ 48 weeks (HR 2.44; 95% CI 1.35–4.40; p = 0.003) to be independent factors for predicting a sustained response. Conclusions. LAM-induced HBeAg seroconversion is not durable in Taiwan. However, a duration of LAM consolidation therapy > 48 weeks may be favorable for maintaining durable HBeAg seroconversion.

Acknowledgements

This study was supported by grant CMRPG NMRPD150081 from Chang Gung Memorial Hospital and grant NSC 95-2314-B-182-017 from the National Science Council, Taiwan. The authors thank C. Y. Lin for her excellent assistance with statistics and C. L. Lee for her secretarial assistance.

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