Clinical Course of Lamivudine Monotherapy in Patients with Decompensated Cirrhosis due to HBeAg negative chronic HBV infection
Clinical Course of Lamivudine Monotherapy in Patients with Decompensated Cirrhosis due to HBeAg negative chronic HBV infection
复制标题
DOI：
10.1046/j.1572-0241.2003.04021.x
复制
发表时间：
2004-01
影响因子：
9.8
通讯作者：
S. Manolakopoulos;S. Karatapanis;J. Elefsiniotis;N. Mathou;J. Vlachogiannakos;E. Iliadou;Anastasios Kougioumtzan;M. Economou;C. Triantos;D. Tzourmakliotis;A. Avgerinos
中科院分区：
文献类型：
--
作者：
S. Manolakopoulos;S. Karatapanis;J. Elefsiniotis;N. Mathou;J. Vlachogiannakos;E. Iliadou;Anastasios Kougioumtzan;M. Economou;C. Triantos;D. Tzourmakliotis;A. Avgerinos
OBJECTIVES:We have evaluated the efficacy of long-term lamivudine monotherapy in patients with decompensated HBeAg-negative/HBV-DNA positive cirrhosis.METHODS:We analyzed the clinical course and outcome of lamivudine treatment in 30 consecutive cirrhotics and compared with 30 HBV untreated historical HBeAg-negative controls matched for age and gender.RESULTS:Significant clinical improvement, defined as a reduction of at least two points in Child-Pugh score was observed in 23 of the 30 treated patients (76.6%) versus none of the 30 patients in the control group (p < 0.0001) after a mean follow-up of 20.6 ± 12.1(±SD) months. There were 10 deaths in the treated group versus 24 in the control group (p= 0.07). Liver-related deaths occurred in five of the eight patients soon after the development of biochemical breakthrough. Patients with clinical improvement had better survival than patients with no improvement (p= 0.04) or those who developed biochemical breakthrough due to YMDD mutants (p= 0.001).CONCLUSIONS:Lamivudine significantly improves liver function in HBeAg-negative decompensated cirrhosis. However, the development of the biochemical breakthrough due to YMDD mutants is associated with fatal outcome.
