Chronic Hepatitis B infection is a major health problem worldwide.
The prognosis is grave for patients with Hepatitis B-related decompensated liver cirrhosis.
Dr Chuan-Mo Lee and colleagues from Taiwan evaluated the effectiveness and the determinants of early mortality of lamivudine treatment.
The researchers included 30 patients with Hep B-related decompensated liver cirrhosis and active viral replication.
|Stage III hepatic encephalopathy is a predictive factor of early mortality|
|Journal of Viral Hepatitis|
The patients were treated with lamivudine 100 mg daily for a median duration of 9 months.
The team reported that among these patients, 5 patients died within 3 months and 2 patients were lost to follow-up at week 8 and 9.
The researchers recorded that 1 patient was treated for less than 6 months and 22 were treated over 6 months.
The team used univariate analysis to reveal predictive factors of early mortality.
Predictive factors of early mortality included total bilirubin, prothrombin time, and Child Turcotte Pugh score.
The team also found that the model of end-stage liver disease score and stage III hepatic encephalopathy were predictive factors of early mortality.
On applying multivariate analysis, the team showed that the independent factor associated with early mortality was stage III encephalopathy.
The researchers observed that among 22 patients, liver function improved markedly after lamivudine therapy.
Of the 9 Hepatitis B e-antigen-positive patients, 3 had seroconversion.
The research team noted that 2 patients had YMDD mutant and virological breakthrough at 41 and 46 weeks.
The researchers reported that 1 of the 2 had hepatocellular carcinoma and died of hepatic failure at week 125 and that the other received adefovir and is doing well.
Dr Lee's team concludes, “Lamivudine appears to have benefits in viral suppression and improvement in liver function with Hepatitis B-related decompensated liver cirrhosis.”
“As noted in prior studies, poor baseline liver function is associated with a poor prognosis in Asian patients with decompensated Hepatitis B cirrhosis treated with lamivudine."