Predictors for early HBeAg loss during lamivudine therapy in HBeAg-positive chronic hepatitis B patients with acute exacerbation

[Guest guest]

http://www.springerlink.com/content/2278v71443807h43/

Hepatology International

DOI: 10.1007/s12072-010-9227-xOnline First¢â

Original Article

Predictors for early HBeAg loss during lamivudine therapy in HBeAg-positive

chronic hepatitis B patients with acute exacerbation

Cheng-Yuan Peng, Chih-Bin Chen, Hsueh-Chou Lai, Wen-Pang Su, Po-Heng Chuang,

Hong-Dar Isaac Wu and Long-Bin Jeng

Abstract

Purpose

To examine the rate of early HBeAg loss and predictors of HBeAg loss in

HBeAg-positive chronic hepatitis B (CHB) patients with acute exacerbation (AE)

treated with lamivudine.

Methods

A total of 146 patients diagnosed with CHB and AEs were included in this

retrospective study. Patients were divided into two groups: decompensated and

compensated.

Results

The mean treatment duration for the decompensated and compensated groups was

18.1 and 19.9 months, respectively. Decompensated patients were significantly

older and had a higher prevalence of cirrhosis and genotype B infection than

compensated patients. Compared to compensated patients, decompensated patients

achieved a higher rate of HBeAg loss (25.8 vs. 14.3%; P = 0.0805) at 3 months of

therapy, a higher rate of serum HBV DNA negativity (53.2 vs. 29.8%; P = 0.0042),

and a lower rate of rtM204V/I mutation (3.2 vs. 16.7%; P = 0.0139) after 12

months of lamivudine therapy. The rates of HBeAg loss after 6 and 12 months of

lamivudine therapy were similar between the two groups. Logistic regression

analysis revealed that female gender and baseline ALT level ¡Ã1,000 IU/L, but

not decompensations, were significant predictors of HBeAg loss at 3 months;

however, only female gender was a significant predictor of HBeAg loss after 6

and 12 months of lamivudine therapy. The early HBeAg losers showed a

significantly higher sustained remission rate off lamivudine therapy.

Conclusions

Female gender and baseline serum ALT level ¡Ã1,000 IU/L were independent

predictors of early HBeAg loss during lamivudine therapy in HBeAg-positive CHB

patients with AE.