Lamivudine treatment for decompensated cirrhosis resulting from chronic hepatitis B

Jean Pierre Villeneuve, Lynn D. Condreay, Bernard Willems, Gilles Pomier-Layrargues, Daphna Fenyves, Marc Bilodeau, Raymond Leduc, Kevork Peltekian, Florence Wong, Mariana Margulies, E. Jenny Heathcote

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Résumé

The prognosis of decompensated cirrhosis resulting from chronic hepatitis B is poor, and the benefits of treatment with interferon are outweighed by serious side effects and by the risk of fatal exacerbation of disease activity. Lamivudine rapidly reduces hepatitis B virus (HBV)-DNA in serum to undetectable levels. We have treated 35 patients with chronic hepatitis B and decompensated cirrhosis with lamivudine 100 mg or 150 mg orally once daily. Pretreatment, all were positive for HBV-DNA in serum. Ten had Child-Pugh class B and 25 had Child-Pugh class C liver disease. Seven patients underwent liver transplantation within 6 months of treatment initiation, 5 patients died within 6 months, and 23 patients were treated for at least 6 months (mean = 19 months). In a majority of these 23 cases, there was a slow but marked improvement in liver function, which was most apparent after 9 months of treatment, with a decrease in serum bilirubin from 67 ± 13 to 30 ± 4 μmol/L (P < .05, baseline vs. 9 months), an increase in serum albumin from 27 ± 1 to 34 ± 1 g/L (P .05), and a decrease in Child-Pugh score from 10.3 ± 0.4 to 7.5 ± 0.5 (P < .05). Three patients developed resistance to lamivudine because of a mutation in the YMDD motif, but liver function did not deteriorate. We conclude that inhibition of viral replication with lamivudine results in a significant improvement of liver function in patients with decompensated HBV cirrhosis, but the long-term benefits remain uncertain.

Langue d'origineEnglish
Pages (de-à)207-210
Nombre de pages4
JournalHepatology
Volume31
Numéro de publication1
DOI
Statut de publicationPublished - 2000

Note bibliographique

Funding Information:
Sources of Support: The Danish Medical Research Council and The 1991 Pharmacy Foundation, Denmark. Objectives: To evaluate the efficacy and safety of benzodiazepine receptor antagonists for acute or chronic hepatic encephalopathy. Design: Systematic review of randomised trials included irrespective of language or publication status. Independent trial inclusion and data extraction by reviewers. Data Sources: Electronic databases, reference lists, and communication with principal authors and pharmaceutical companies. Main Outcomes Measures: Survival, recovery, improvement, and adverse events.

ASJC Scopus Subject Areas

  • Hepatology

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