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Vol. 48, No. 2-3, 2005
Issue release date: March–June 2005
Section title: Original Paper
Intervirology 2005;48:174–182
(DOI:10.1159/000081746)

Virological and Biochemical Relapse after Discontinuation of Lamivudine Monotherapy for Chronic Hepatitis B in Japan: Comparison with Breakthrough Hepatitis during Long-Term Treatment

Akuta N.a · Suzuki F.a · Kobayashi M.b · Matsuda M.b · Sato J.b · Suzuki Y.a · Sezaki H.a · Hosaka T.a · Someya T.a · Kobayashi M.a · Saitoh S.a · Arase Y.a · Ikeda K.a · Kumada H.a
aDepartment of Gastroenterology and bLiver Research Laboratory, Toranomon Hospital, Tokyo, Japan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/7/2004
Accepted: 8/11/2004
Published online: 3/24/2005
Issue release date: March–June 2005

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 4

ISSN: 0300-5526 (Print)
eISSN: 1423-0100 (Online)

For additional information: http://www.karger.com/INT

Abstract

Objective: Comparison of virological and biochemical relapse in patients with chronic hepatitis B, based on continuation or discontinuation of lamivudine monotherapy. Methods: In Japanese genotype C-dominant hepatitis B patients, 25 patients who stopped treatment at normal levels of alanine transferase (ALT) were retrospectively compared with 75 patients who continued treatment. Both groups were matched for age, sex, and observation period after start of treatment. We investigated the relapse rates, and evaluated predictive factors for relapse and efficacy of retreatment of the discontinuous group. Results: Virological and biochemical relapse occurred significantly earlier in the discontinuous than continuous group, and the peak levels and ratios of peak to pretreatment levels of serum bilirubin and ALT after relapse were not significantly different between the two groups. Multivariate analysis identified three independent factors at discontinuation of treatment associated with early biochemical relapse: HBeAg positivity, presence of liver cirrhosis, detection of basic core promoter mutant. Normalization of ALT levels with retreatment occurred in 62.5% of patients, but 2 HBeAg-positive patients retreated after the emergence of YMDD motif mutant developed severe relapse with hyperbilirubinemia. Conclusion: Our results in Japanese patients with genotype C-dominant hepatitis B suggest that discontinuation of lamivudine monotherapy, and retreatment after the emergence of YMDD mutant should be given attention.

© 2005 S. Karger AG, Basel


  

Author Contacts

Norio Akuta, MD
Department of Gastroenterology, Toranomon Hospital
2-2-2 Toranomon, Minato-ku
Tokyo, 105-0001 (Japan)
Tel. +81 44 877 5111, Fax +81 44 860 1623

  

Article Information

Number of Print Pages : 9
Number of Figures : 2, Number of Tables : 4, Number of References : 52

  

Publication Details

Intervirology (International Journal of Basic and Medical Virology)

Vol. 48, No. 2-3, Year 2005 (Cover Date: March-June 2005)

Journal Editor: U.G. Liebert, Leipzig
ISSN: 0300–5526 (print), 1423–0100 (Online)

For additional information: http://www.karger.com/int


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/7/2004
Accepted: 8/11/2004
Published online: 3/24/2005
Issue release date: March–June 2005

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 4

ISSN: 0300-5526 (Print)
eISSN: 1423-0100 (Online)

For additional information: http://www.karger.com/INT


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