Clinical outcome of HBeAg-negative chronic hepatitis B in relation to virological response to lamivudine

Pier Luigi Almasio, Vito Di Marco, Antonio Craxi, Pietro Andreone, Mario Rizzetto, Alfredo Marzano, Teresa Santantonio, Pietro Lampertico

Risultato della ricerca: Article

240 Citazioni (Scopus)

Abstract

AbstractThe effect of lamivudine treatment on the outcome of patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis is unclear. In a retrospective multicenter study, we have analyzed the virological events observed during lamivudine therapy in patients with HBeAg-negative chronic hepatitis and evaluated the correlation between virological response and clinical outcomes. Among 656 patients (mean age 49.1 years) included in the database, 54% had chronic hepatitis, 30% had Child-Turcotte-Pugh (CTP) A cirrhosis, and 16% had CTP B/C cirrhosis. On therapy (median 22 months, range 1-66), a virological response was obtained in 616 patients (93.9%). The rate of maintained virological response was 39% after 4 years. During follow-up, 47 (7.2%) patients underwent liver transplantation, liver disease worsened in 31 (4.7%), hepatocellular carcinoma (HCC) developed in 31 (4.7%), and 24 patients (3.6%) died of liver-related causes. Patients who had cirrhosis and who maintained virological response were less likely than those with viral breakthrough to develop HCC (P <.001) and disease worsening (P <.001). Survival was better in CTP A patients with cirrhosis and maintained virological response (P =.01 by rank test). Multivariate analysis revealed that presence of cirrhosis and viral breakthrough were independently related to mortality and development of HCC. In conclusion, lamivudine is highly effective in reducing viral load in HBeAg-negative patients. After 4 years of therapy, 39% of patients maintain a virological and biochemical response. Loss of virological response may lead to clinical deterioration in patients with cirrhosis.
Lingua originaleEnglish
pagine (da-a)883-891
Numero di pagine9
RivistaHEPATOLOGY
Volume40
Stato di pubblicazionePublished - 2004

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Lamivudine
Hepatitis B e Antigens
Chronic Hepatitis B
Fibrosis
Chronic Hepatitis
Hepatocellular Carcinoma
Viral Load
Liver Transplantation
Multicenter Studies
Liver Diseases
Therapeutics
Multivariate Analysis
Retrospective Studies
Databases

All Science Journal Classification (ASJC) codes

  • Hepatology

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Clinical outcome of HBeAg-negative chronic hepatitis B in relation to virological response to lamivudine. / Almasio, Pier Luigi; Di Marco, Vito; Craxi, Antonio; Andreone, Pietro; Rizzetto, Mario; Marzano, Alfredo; Santantonio, Teresa; Lampertico, Pietro.

In: HEPATOLOGY, Vol. 40, 2004, pag. 883-891.

Risultato della ricerca: Article

Almasio, PL, Di Marco, V, Craxi, A, Andreone, P, Rizzetto, M, Marzano, A, Santantonio, T & Lampertico, P 2004, 'Clinical outcome of HBeAg-negative chronic hepatitis B in relation to virological response to lamivudine', HEPATOLOGY, vol. 40, pagg. 883-891.
Almasio, Pier Luigi ; Di Marco, Vito ; Craxi, Antonio ; Andreone, Pietro ; Rizzetto, Mario ; Marzano, Alfredo ; Santantonio, Teresa ; Lampertico, Pietro. / Clinical outcome of HBeAg-negative chronic hepatitis B in relation to virological response to lamivudine. In: HEPATOLOGY. 2004 ; Vol. 40. pagg. 883-891.
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abstract = "AbstractThe effect of lamivudine treatment on the outcome of patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis is unclear. In a retrospective multicenter study, we have analyzed the virological events observed during lamivudine therapy in patients with HBeAg-negative chronic hepatitis and evaluated the correlation between virological response and clinical outcomes. Among 656 patients (mean age 49.1 years) included in the database, 54{\%} had chronic hepatitis, 30{\%} had Child-Turcotte-Pugh (CTP) A cirrhosis, and 16{\%} had CTP B/C cirrhosis. On therapy (median 22 months, range 1-66), a virological response was obtained in 616 patients (93.9{\%}). The rate of maintained virological response was 39{\%} after 4 years. During follow-up, 47 (7.2{\%}) patients underwent liver transplantation, liver disease worsened in 31 (4.7{\%}), hepatocellular carcinoma (HCC) developed in 31 (4.7{\%}), and 24 patients (3.6{\%}) died of liver-related causes. Patients who had cirrhosis and who maintained virological response were less likely than those with viral breakthrough to develop HCC (P <.001) and disease worsening (P <.001). Survival was better in CTP A patients with cirrhosis and maintained virological response (P =.01 by rank test). Multivariate analysis revealed that presence of cirrhosis and viral breakthrough were independently related to mortality and development of HCC. In conclusion, lamivudine is highly effective in reducing viral load in HBeAg-negative patients. After 4 years of therapy, 39{\%} of patients maintain a virological and biochemical response. Loss of virological response may lead to clinical deterioration in patients with cirrhosis.",
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T1 - Clinical outcome of HBeAg-negative chronic hepatitis B in relation to virological response to lamivudine

AU - Almasio, Pier Luigi

AU - Di Marco, Vito

AU - Craxi, Antonio

AU - Andreone, Pietro

AU - Rizzetto, Mario

AU - Marzano, Alfredo

AU - Santantonio, Teresa

AU - Lampertico, Pietro

PY - 2004

Y1 - 2004

N2 - AbstractThe effect of lamivudine treatment on the outcome of patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis is unclear. In a retrospective multicenter study, we have analyzed the virological events observed during lamivudine therapy in patients with HBeAg-negative chronic hepatitis and evaluated the correlation between virological response and clinical outcomes. Among 656 patients (mean age 49.1 years) included in the database, 54% had chronic hepatitis, 30% had Child-Turcotte-Pugh (CTP) A cirrhosis, and 16% had CTP B/C cirrhosis. On therapy (median 22 months, range 1-66), a virological response was obtained in 616 patients (93.9%). The rate of maintained virological response was 39% after 4 years. During follow-up, 47 (7.2%) patients underwent liver transplantation, liver disease worsened in 31 (4.7%), hepatocellular carcinoma (HCC) developed in 31 (4.7%), and 24 patients (3.6%) died of liver-related causes. Patients who had cirrhosis and who maintained virological response were less likely than those with viral breakthrough to develop HCC (P <.001) and disease worsening (P <.001). Survival was better in CTP A patients with cirrhosis and maintained virological response (P =.01 by rank test). Multivariate analysis revealed that presence of cirrhosis and viral breakthrough were independently related to mortality and development of HCC. In conclusion, lamivudine is highly effective in reducing viral load in HBeAg-negative patients. After 4 years of therapy, 39% of patients maintain a virological and biochemical response. Loss of virological response may lead to clinical deterioration in patients with cirrhosis.

AB - AbstractThe effect of lamivudine treatment on the outcome of patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis is unclear. In a retrospective multicenter study, we have analyzed the virological events observed during lamivudine therapy in patients with HBeAg-negative chronic hepatitis and evaluated the correlation between virological response and clinical outcomes. Among 656 patients (mean age 49.1 years) included in the database, 54% had chronic hepatitis, 30% had Child-Turcotte-Pugh (CTP) A cirrhosis, and 16% had CTP B/C cirrhosis. On therapy (median 22 months, range 1-66), a virological response was obtained in 616 patients (93.9%). The rate of maintained virological response was 39% after 4 years. During follow-up, 47 (7.2%) patients underwent liver transplantation, liver disease worsened in 31 (4.7%), hepatocellular carcinoma (HCC) developed in 31 (4.7%), and 24 patients (3.6%) died of liver-related causes. Patients who had cirrhosis and who maintained virological response were less likely than those with viral breakthrough to develop HCC (P <.001) and disease worsening (P <.001). Survival was better in CTP A patients with cirrhosis and maintained virological response (P =.01 by rank test). Multivariate analysis revealed that presence of cirrhosis and viral breakthrough were independently related to mortality and development of HCC. In conclusion, lamivudine is highly effective in reducing viral load in HBeAg-negative patients. After 4 years of therapy, 39% of patients maintain a virological and biochemical response. Loss of virological response may lead to clinical deterioration in patients with cirrhosis.

KW - Epatite cronica da Virus B

KW - trattamento antivirale

UR - http://hdl.handle.net/10447/13811

M3 - Article

VL - 40

SP - 883

EP - 891

JO - HEPATOLOGY

JF - HEPATOLOGY

SN - 0270-9139

ER -