Treatment of chronic hepatitis B with lamivudine.

OBJECTIVE

To study the efficacy of antiviral drug lamivudine for treatment of chronic hepatitis B in Pakistani population.

DESIGN

Experimental study.

PLACE AND DURATION OF STUDY

A tertiary Care Center, from January 2000 to January 2004.

PATIENTS AND METHODS

Patients who had positive hepatitis B surface antigen (HBsAg) and elevated ALT were recruited. Both hepatitis Be antigen (HBeAg) positive and HBeAg negative patients were included. Treatment was given with lamivudine 100mg once a day for 12 months and they were followed every 2-3 months with ALT, HBeAg, and in certain cases with, HBV DNA (PCR). Those patients who were HBeAg positive were considered to have achieved end of treatment response (ETR) when ALT was normal and HBeAg was negative and this was documented at two consecutive occasions, at least one month apart. Those patients who were HBeAg negative were considered to have achieved ETR when their ALT was normal and HBV DNA was undetectable. Patients were followed for further 6 months to evaluate for any relapse.

RESULTS

A total of 105 patients were included. Eighty-two (78.1%) were males and 23 (21.9%) were females. Mean ALT of all patients was 87.15 +/- 46.01 u/dl. Seventy-two HBeAg positive and 15 HBeAg negative patients completed treatment with 23.6 % and 80.0 % response rate respectively (p <0.001).

CONCLUSION

The response of lamivudine in chronic hepatitis B in Pakistani population is encouraging in HBeAg negative patients but is rather low in those who are HBeAg positive.