Semin Liver Dis 2004; 24: 31-36
DOI: 10.1055/s-2004-828676
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Clinical Trial Results and Treatment Resistance with Lamivudine in Hepatitis B

Teresa L. Wright1
  • 1Professor of Medicine, Department of Veterans Affairs Medical Center, University of California, San Francisco, California
Further Information

Publication History

Publication Date:
11 June 2004 (online)

Lamivudine is an effective first-line therapy for chronic hepatitis B virus (HBV) infection, accomplishing the goals of viral suppression, normalization of alanine aminotransferase (ALT) levels, histological improvement, and seroconversion. In the lamivudine clinical trials, up to 32% of patients positive for hepatitis B e antigen (HBeAg) lost HBeAg after 1 year of treatment, and approximately 18% achieved HBeAg seroconversion. ALT levels greater than five times the upper limit of normal increased the likelihood of HBeAg loss. The rates of seroconversion and resistance both increase with the length of treatment. In HBeAg-negative patients, two thirds showed response after 6 to 12 months of therapy, but this response diminished over time despite continued treatment, largely due to the emergence of resistance. Resistance is present in nearly 70% of patients at 5 years. Resistance reverses prior biochemical, virological, and histological gains and can lead to progressive liver failure. Careful patient selection is important, therefore, to maximize the potential for a treatment response under limited therapy.

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Teresa L WrightM.D. 

4150 Clement St, 111B

San Francisco, CA 94121

Email: twright@itsa.ucsf.edu

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