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World J Gastroenterol. 2005 Jul 28;11(28):4344-50.

Outcome of lamivudine-resistant hepatitis B virus is generally benign except in cirrhotics.

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1
Division of Gastroenterology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, 119074 Singapore.

Abstract

AIM:

We set to determine factors that determine clinical severity after the development of resistance.

METHODS:

Thirty-five Asian patients with genotypic lamivudine resistance were analyzed in three groups: 13/35 (37%) were non-cirrhotics with normal pre-treatment ALT (Group IA), 12/35 (34%) were non-cirrhotics with elevated pre-treatment ALT (Group IB), and 10/35 (29%) were cirrhotics (Group II). Patients were followed for a median of 98 wk (range 26-220) after the emergence of genotypic resistance.

RESULTS:

Group IA patients tended to retain normal ALT. Group IB patients showed initial improvement of ALT with lamivudine but 9/12 patients (75%) developed abnormal ALT subsequently. On follow-up however, this persisted in only 33%. Group II patients also showed improvement while on treatment, but they deteriorated with the emergence of resistance with 30% death from decompensated liver disease. Pretreatment ALT levels and CPT score (in the cirrhotic group) were predictive of clinical resistance and correlated with peak ALT levels and CPT score.

CONCLUSION:

The phenotype of lamivudine-resistant HBV correlated with the pretreatment phenotype. The clinical course was generally benign in non-cirrhotics. However, cirrhotics had a high risk of progression and death (30%) with the development of lamivudine resistance.

PMID:
16038032
PMCID:
PMC4434660
[Indexed for MEDLINE]
Free PMC Article
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