Lamivudine maintenance beyond one year after HBeAg seroconversion is a major factor for sustained virologic response in HBeAg-positive chronic hepatitis B

Hyun Woong Lee, Heon Ju Lee, Jae Seok Hwang, Joo Hyun Sohn, Jae Young Jang, Ki Jun Han, Junyong Park, doyoung kim, SangHoon Ahn, Yong Han Paik, Chun Kyon Lee, Kwan Sik Lee, Chae Yoon Chon, KwangHyub Han

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

The reported durability of virologic response after successful lamivudine monotherapy is variable, and the question remains as to whether virologic responses can be maintained over an extended follow-up period. The aim of this study was to investigate posttreatment durability, the optimal duration of additional treatment after HBeAg clearance or seroconversion, and determinants for sustained virologic response (SVR) following lamivudine monotherapy in patients with HBeAg-positive chronic hepatitis B (CHB). From January 1999 to August 2004, 178 Korean patients with HBeAg-positiveCHBwere treated with lamivudine and achieved complete responses, defined as a loss of serum HBeAg and hepatitis B virus DNA, and alanine aminotransferase normalization. The mean duration of lamivudine monotherapy was 26 months (range, 12-77). SVR was maintained in 138 patients (77.5%). Host and viral factors were compared between 138 patients with SVR and 40 patients whose response was not sustained. The cumulative relapse rates increased from 15.9% at 1 year to 30.2% at 5 years, with a mean time to relapse after cessation of lamivudine of 12 months (range, 7-42). Most relapses occurred within 2 years after discontinuation of lamivudine (33/40, 82.5%).Onmultivariate analysis, age≤40 years and additional treatment for more than 12 months after HBeAg clearance or seroconversion were independent factors for SVR. Conclusion: The lamivudine-induced virologic response was durable in patients under 40 years old and those receiving lamivudine for more than 12 months after HBeAg clearance or seroconversion. Age and additional treatment were major predictive factors for SVR.

Original languageEnglish
Pages (from-to)415-421
Number of pages7
JournalHepatology
Volume51
Issue number2
DOIs
Publication statusPublished - 2010 Feb 1

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Lamivudine
Hepatitis B e Antigens
Chronic Hepatitis B
Maintenance
Recurrence
Sustained Virologic Response
Seroconversion
Alanine Transaminase
Hepatitis B virus
Therapeutics
DNA
Serum

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Lee, Hyun Woong ; Lee, Heon Ju ; Hwang, Jae Seok ; Sohn, Joo Hyun ; Jang, Jae Young ; Han, Ki Jun ; Park, Junyong ; kim, doyoung ; Ahn, SangHoon ; Paik, Yong Han ; Lee, Chun Kyon ; Lee, Kwan Sik ; Chon, Chae Yoon ; Han, KwangHyub. / Lamivudine maintenance beyond one year after HBeAg seroconversion is a major factor for sustained virologic response in HBeAg-positive chronic hepatitis B. In: Hepatology. 2010 ; Vol. 51, No. 2. pp. 415-421.
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title = "Lamivudine maintenance beyond one year after HBeAg seroconversion is a major factor for sustained virologic response in HBeAg-positive chronic hepatitis B",
abstract = "The reported durability of virologic response after successful lamivudine monotherapy is variable, and the question remains as to whether virologic responses can be maintained over an extended follow-up period. The aim of this study was to investigate posttreatment durability, the optimal duration of additional treatment after HBeAg clearance or seroconversion, and determinants for sustained virologic response (SVR) following lamivudine monotherapy in patients with HBeAg-positive chronic hepatitis B (CHB). From January 1999 to August 2004, 178 Korean patients with HBeAg-positiveCHBwere treated with lamivudine and achieved complete responses, defined as a loss of serum HBeAg and hepatitis B virus DNA, and alanine aminotransferase normalization. The mean duration of lamivudine monotherapy was 26 months (range, 12-77). SVR was maintained in 138 patients (77.5{\%}). Host and viral factors were compared between 138 patients with SVR and 40 patients whose response was not sustained. The cumulative relapse rates increased from 15.9{\%} at 1 year to 30.2{\%} at 5 years, with a mean time to relapse after cessation of lamivudine of 12 months (range, 7-42). Most relapses occurred within 2 years after discontinuation of lamivudine (33/40, 82.5{\%}).Onmultivariate analysis, age≤40 years and additional treatment for more than 12 months after HBeAg clearance or seroconversion were independent factors for SVR. Conclusion: The lamivudine-induced virologic response was durable in patients under 40 years old and those receiving lamivudine for more than 12 months after HBeAg clearance or seroconversion. Age and additional treatment were major predictive factors for SVR.",
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Lamivudine maintenance beyond one year after HBeAg seroconversion is a major factor for sustained virologic response in HBeAg-positive chronic hepatitis B. / Lee, Hyun Woong; Lee, Heon Ju; Hwang, Jae Seok; Sohn, Joo Hyun; Jang, Jae Young; Han, Ki Jun; Park, Junyong; kim, doyoung; Ahn, SangHoon; Paik, Yong Han; Lee, Chun Kyon; Lee, Kwan Sik; Chon, Chae Yoon; Han, KwangHyub.

In: Hepatology, Vol. 51, No. 2, 01.02.2010, p. 415-421.

Research output: Contribution to journalArticle

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T1 - Lamivudine maintenance beyond one year after HBeAg seroconversion is a major factor for sustained virologic response in HBeAg-positive chronic hepatitis B

AU - Lee, Hyun Woong

AU - Lee, Heon Ju

AU - Hwang, Jae Seok

AU - Sohn, Joo Hyun

AU - Jang, Jae Young

AU - Han, Ki Jun

AU - Park, Junyong

AU - kim, doyoung

AU - Ahn, SangHoon

AU - Paik, Yong Han

AU - Lee, Chun Kyon

AU - Lee, Kwan Sik

AU - Chon, Chae Yoon

AU - Han, KwangHyub

PY - 2010/2/1

Y1 - 2010/2/1

N2 - The reported durability of virologic response after successful lamivudine monotherapy is variable, and the question remains as to whether virologic responses can be maintained over an extended follow-up period. The aim of this study was to investigate posttreatment durability, the optimal duration of additional treatment after HBeAg clearance or seroconversion, and determinants for sustained virologic response (SVR) following lamivudine monotherapy in patients with HBeAg-positive chronic hepatitis B (CHB). From January 1999 to August 2004, 178 Korean patients with HBeAg-positiveCHBwere treated with lamivudine and achieved complete responses, defined as a loss of serum HBeAg and hepatitis B virus DNA, and alanine aminotransferase normalization. The mean duration of lamivudine monotherapy was 26 months (range, 12-77). SVR was maintained in 138 patients (77.5%). Host and viral factors were compared between 138 patients with SVR and 40 patients whose response was not sustained. The cumulative relapse rates increased from 15.9% at 1 year to 30.2% at 5 years, with a mean time to relapse after cessation of lamivudine of 12 months (range, 7-42). Most relapses occurred within 2 years after discontinuation of lamivudine (33/40, 82.5%).Onmultivariate analysis, age≤40 years and additional treatment for more than 12 months after HBeAg clearance or seroconversion were independent factors for SVR. Conclusion: The lamivudine-induced virologic response was durable in patients under 40 years old and those receiving lamivudine for more than 12 months after HBeAg clearance or seroconversion. Age and additional treatment were major predictive factors for SVR.

AB - The reported durability of virologic response after successful lamivudine monotherapy is variable, and the question remains as to whether virologic responses can be maintained over an extended follow-up period. The aim of this study was to investigate posttreatment durability, the optimal duration of additional treatment after HBeAg clearance or seroconversion, and determinants for sustained virologic response (SVR) following lamivudine monotherapy in patients with HBeAg-positive chronic hepatitis B (CHB). From January 1999 to August 2004, 178 Korean patients with HBeAg-positiveCHBwere treated with lamivudine and achieved complete responses, defined as a loss of serum HBeAg and hepatitis B virus DNA, and alanine aminotransferase normalization. The mean duration of lamivudine monotherapy was 26 months (range, 12-77). SVR was maintained in 138 patients (77.5%). Host and viral factors were compared between 138 patients with SVR and 40 patients whose response was not sustained. The cumulative relapse rates increased from 15.9% at 1 year to 30.2% at 5 years, with a mean time to relapse after cessation of lamivudine of 12 months (range, 7-42). Most relapses occurred within 2 years after discontinuation of lamivudine (33/40, 82.5%).Onmultivariate analysis, age≤40 years and additional treatment for more than 12 months after HBeAg clearance or seroconversion were independent factors for SVR. Conclusion: The lamivudine-induced virologic response was durable in patients under 40 years old and those receiving lamivudine for more than 12 months after HBeAg clearance or seroconversion. Age and additional treatment were major predictive factors for SVR.

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