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 28 July 2016

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News

Lamivudine treatment for chronic hepatitis B infection

Children with chronic hepatitis B infection treated with lamivudine, following failure of interferon therapy, show decreased HBV replication and improved ALT values, find researchers in the March issue of the Pediatric Infectious Diseases Journal.

News image

Lamivudine is a potent inhibitor of hepatitis B virus (HBV) replication.

In this study, researchers from Israel assessed the results of lamivudine treatment in children with chronic hepatitis B infection who did not respond to interferon treatment.

Lamivudine (3 mg/kg/day) was given to 20 children and adolescents (aged 8 to 19 years) with chronic hepatitis B, for a period of 52 weeks. The children had previously been treated with interferon, between 2 and 5 years earlier.

The researchers evaluated virologic and biochemical responses, the occurrence of YMDD mutants, and adverse effects.

At the end of 1 year, HBV DNA declined by 95% in all patients.
Pediatric Infectious Diseases Journal

The team found that all children were HBV DNA+, hepatitis B e antigen (HBeAg)+/anti-hepatitis B e antibody- at start of treatment.

At the end of 1 year, HBV DNA declined by 95% in all patients, and 44% had sustained undetectable HBV DNA by hybridization assay.

In addition, median pretreatment alanine aminotransferase (ALT) x 1.5 upper limit of normal, decreased to ALT x 0.9 upper limit of normal after 1 year.

Of the 20 children, 1 became HBeAg-negative.

However, the team detected YMDD mutants in 65% of children after 1 year of lamivudine treatment.

Among children with YMDD mutant variants, 54% maintained normal ALT values and 45% had undetectable HBV DNA by hybridization assay.

No adverse effects were observed.

Dr Corina Hartman's team concluded, "Children with chronic hepatitis B infection treated with lamivudine after failure of interferon therapy had decreased HBV replication and improved ALT values".

"However, lamivudine treatment resulted in an exceptionally high rate of lamivudine-resistant mutants and low HBeAg seroconversion rate."

Pediatr Infect Dis J 2003; 22(3): 224-9
14 March 2003

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