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."