Comparison of clinical outcome between patients continuing and discontinuing lamivudine therapy after biochemical breakthrough of YMDD mutants

[Guest guest]

J Hepatol. 2004 Sep;41(3):454-61.

Comparison of clinical outcome between patients continuing and discontinuing

lamivudine therapy after biochemical breakthrough of YMDD mutants.

Chen CH, Lee CM, Lu SN, Wang JH, Tung HD, Hung CH, Chen WJ, Changchien CS.

Division of Hepatogastroenterology, Department of Internal Medicine,

Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan.

BACKGROUND/AIMS: The aim of this study was to compare the clinical outcome

between patients continuing and discontinuing lamivudine therapy after the

biochemical breakthrough of hepatitis B virus

tyrosine-methionine-aspartate-aspartate (YMDD) mutant. METHODS: YMDD mutants

were detected in 51 chronic hepatitis B patients who experienced a flare-up

of alanine aminotransferase (ALT) during lamivudine treatment. Twenty-seven

of them discontinued lamivudine therapy (group A), and 24 continued therapy

(group after biochemical breakthrough. The follow-up period was 12 months

in both the groups. RESULTS: There was no significant difference between

groups A and B in the incidence and severity of ALT peaks and hepatic

decompensation within the first 3 months after biochemical breakthrough.

After the fourth month of biochemical breakthrough, however, group A

experienced acute exacerbation more frequently [20/26 (77%) vs. 7/23 (30%);

P=0.002] and higher ALT peaks than group B. The same result was found when

the patients were divided into naive and retreated or cirrhotic and

non-cirrhotic groups. Hepatic decompensation at the onset of biochemical

breakthrough was associated with higher mortality (OR=70, 95%

CI=6.06-807.75). CONCLUSIONS: Patients who discontinued lamivudine therapy

increased the frequency of flare-ups and higher ALT peaks than those who

continued therapy after 4 months post-breakthrough.

PMID: 15336449 [PubMed - in process]

[Guest guest]

J Hepatol. 2004 Sep;41(3):454-61.

Comparison of clinical outcome between patients continuing and discontinuing

lamivudine therapy after biochemical breakthrough of YMDD mutants.

Chen CH, Lee CM, Lu SN, Wang JH, Tung HD, Hung CH, Chen WJ, Changchien CS.

Division of Hepatogastroenterology, Department of Internal Medicine,

Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan.

BACKGROUND/AIMS: The aim of this study was to compare the clinical outcome

between patients continuing and discontinuing lamivudine therapy after the

biochemical breakthrough of hepatitis B virus

tyrosine-methionine-aspartate-aspartate (YMDD) mutant. METHODS: YMDD mutants

were detected in 51 chronic hepatitis B patients who experienced a flare-up

of alanine aminotransferase (ALT) during lamivudine treatment. Twenty-seven

of them discontinued lamivudine therapy (group A), and 24 continued therapy

(group after biochemical breakthrough. The follow-up period was 12 months

in both the groups. RESULTS: There was no significant difference between

groups A and B in the incidence and severity of ALT peaks and hepatic

decompensation within the first 3 months after biochemical breakthrough.

After the fourth month of biochemical breakthrough, however, group A

experienced acute exacerbation more frequently [20/26 (77%) vs. 7/23 (30%);

P=0.002] and higher ALT peaks than group B. The same result was found when

the patients were divided into naive and retreated or cirrhotic and

non-cirrhotic groups. Hepatic decompensation at the onset of biochemical

breakthrough was associated with higher mortality (OR=70, 95%

CI=6.06-807.75). CONCLUSIONS: Patients who discontinued lamivudine therapy

increased the frequency of flare-ups and higher ALT peaks than those who

continued therapy after 4 months post-breakthrough.

PMID: 15336449 [PubMed - in process]

[Guest guest]

J Hepatol. 2004 Sep;41(3):454-61.

Comparison of clinical outcome between patients continuing and discontinuing

lamivudine therapy after biochemical breakthrough of YMDD mutants.

Chen CH, Lee CM, Lu SN, Wang JH, Tung HD, Hung CH, Chen WJ, Changchien CS.

Division of Hepatogastroenterology, Department of Internal Medicine,

Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan.

BACKGROUND/AIMS: The aim of this study was to compare the clinical outcome

between patients continuing and discontinuing lamivudine therapy after the

biochemical breakthrough of hepatitis B virus

tyrosine-methionine-aspartate-aspartate (YMDD) mutant. METHODS: YMDD mutants

were detected in 51 chronic hepatitis B patients who experienced a flare-up

of alanine aminotransferase (ALT) during lamivudine treatment. Twenty-seven

of them discontinued lamivudine therapy (group A), and 24 continued therapy

(group after biochemical breakthrough. The follow-up period was 12 months

in both the groups. RESULTS: There was no significant difference between

groups A and B in the incidence and severity of ALT peaks and hepatic

decompensation within the first 3 months after biochemical breakthrough.

After the fourth month of biochemical breakthrough, however, group A

experienced acute exacerbation more frequently [20/26 (77%) vs. 7/23 (30%);

P=0.002] and higher ALT peaks than group B. The same result was found when

the patients were divided into naive and retreated or cirrhotic and

non-cirrhotic groups. Hepatic decompensation at the onset of biochemical

breakthrough was associated with higher mortality (OR=70, 95%

CI=6.06-807.75). CONCLUSIONS: Patients who discontinued lamivudine therapy

increased the frequency of flare-ups and higher ALT peaks than those who

continued therapy after 4 months post-breakthrough.

PMID: 15336449 [PubMed - in process]

[Guest guest]

J Hepatol. 2004 Sep;41(3):454-61.

Comparison of clinical outcome between patients continuing and discontinuing

lamivudine therapy after biochemical breakthrough of YMDD mutants.

Chen CH, Lee CM, Lu SN, Wang JH, Tung HD, Hung CH, Chen WJ, Changchien CS.

Division of Hepatogastroenterology, Department of Internal Medicine,

Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan.

BACKGROUND/AIMS: The aim of this study was to compare the clinical outcome

between patients continuing and discontinuing lamivudine therapy after the

biochemical breakthrough of hepatitis B virus

tyrosine-methionine-aspartate-aspartate (YMDD) mutant. METHODS: YMDD mutants

were detected in 51 chronic hepatitis B patients who experienced a flare-up

of alanine aminotransferase (ALT) during lamivudine treatment. Twenty-seven

of them discontinued lamivudine therapy (group A), and 24 continued therapy

(group after biochemical breakthrough. The follow-up period was 12 months

in both the groups. RESULTS: There was no significant difference between

groups A and B in the incidence and severity of ALT peaks and hepatic

decompensation within the first 3 months after biochemical breakthrough.

After the fourth month of biochemical breakthrough, however, group A

experienced acute exacerbation more frequently [20/26 (77%) vs. 7/23 (30%);

P=0.002] and higher ALT peaks than group B. The same result was found when

the patients were divided into naive and retreated or cirrhotic and

non-cirrhotic groups. Hepatic decompensation at the onset of biochemical

breakthrough was associated with higher mortality (OR=70, 95%

CI=6.06-807.75). CONCLUSIONS: Patients who discontinued lamivudine therapy

increased the frequency of flare-ups and higher ALT peaks than those who

continued therapy after 4 months post-breakthrough.

PMID: 15336449 [PubMed - in process]