Hepatology International

, Volume 5, Issue 1, pp 586–596

Predictors for early HBeAg loss during lamivudine therapy in HBeAg-positive chronic hepatitis B patients with acute exacerbation

  • Cheng-Yuan Peng
  • Chih-Bin Chen
  • Hsueh-Chou Lai
  • Wen-Pang Su
  • Po-Heng Chuang
  • Hong-Dar Isaac Wu
  • Long-Bin Jeng
Original Article

DOI: 10.1007/s12072-010-9227-x

Cite this article as:
Peng, CY., Chen, CB., Lai, HC. et al. Hepatol Int (2011) 5: 586. doi:10.1007/s12072-010-9227-x
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Abstract

Purpose

To examine the rate of early HBeAg loss and predictors of HBeAg loss in HBeAg-positive chronic hepatitis B (CHB) patients with acute exacerbation (AE) treated with lamivudine.

Methods

A total of 146 patients diagnosed with CHB and AEs were included in this retrospective study. Patients were divided into two groups: decompensated and compensated.

Results

The mean treatment duration for the decompensated and compensated groups was 18.1 and 19.9 months, respectively. Decompensated patients were significantly older and had a higher prevalence of cirrhosis and genotype B infection than compensated patients. Compared to compensated patients, decompensated patients achieved a higher rate of HBeAg loss (25.8 vs. 14.3%; P = 0.0805) at 3 months of therapy, a higher rate of serum HBV DNA negativity (53.2 vs. 29.8%; P = 0.0042), and a lower rate of rtM204V/I mutation (3.2 vs. 16.7%; P = 0.0139) after 12 months of lamivudine therapy. The rates of HBeAg loss after 6 and 12 months of lamivudine therapy were similar between the two groups. Logistic regression analysis revealed that female gender and baseline ALT level ≥1,000 IU/L, but not decompensations, were significant predictors of HBeAg loss at 3 months; however, only female gender was a significant predictor of HBeAg loss after 6 and 12 months of lamivudine therapy. The early HBeAg losers showed a significantly higher sustained remission rate off lamivudine therapy.

Conclusions

Female gender and baseline serum ALT level ≥1,000 IU/L were independent predictors of early HBeAg loss during lamivudine therapy in HBeAg-positive CHB patients with AE.

Keywords

Acute exacerbation Chronic hepatitis B Decompensation HBeAg loss Lamivudine 

Abbreviations

AE

Acute exacerbation

ALT

Alanine aminotransferase

AFP

Alpha-fetoprotein

AST

Aspartate aminotransferase

CHB

Chronic hepatitis B

CI

Confidence interval

HAV

Hepatitis A virus

HBeAg

Hepatitis B e antigen

HBV

Hepatitis B virus

HCV

Hepatitis C virus

HDV

Hepatitis D virus

OR

Odds ratio

PT

Prothrombin time

RFLP

Restriction fragment length polymorphism

rtM204V/I

Reverse transcriptase domain 204 methionine-to-valine/isoleucine mutation

SD

Standard deviation

ULN

Upper limit of normal

Supplementary material

12072_2010_9227_MOESM1_ESM.pdf (78 kb)
Supplementary material 1 (PDF 78 kb)

Copyright information

© Asian Pacific Association for the Study of the Liver 2010

Authors and Affiliations

  • Cheng-Yuan Peng
    • 1
  • Chih-Bin Chen
    • 1
  • Hsueh-Chou Lai
    • 1
  • Wen-Pang Su
    • 1
  • Po-Heng Chuang
    • 1
  • Hong-Dar Isaac Wu
    • 2
  • Long-Bin Jeng
    • 3
  1. 1.Division of Hepatogastroenterology, Department of Internal MedicineChina Medical University HospitalTaichungTaiwan
  2. 2.Department of Applied Mathematics, Institute of StatisticsNational Chung-Hsing UniversityTaichungTaiwan
  3. 3.Department of SurgeryChina Medical University HospitalTaichungTaiwan

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