Predicting Relapse after Cessation of Lamivudine Monotherapy for Chronic Hepatitis B Virus Infection

[Guest guest]

Clinical Infectious Diseases 2004;38:000

© 2004 by the Infectious Diseases Society of America. All rights reserved.

1058-4838/2004/3804-00XX$15.00

Predicting Relapse after Cessation of Lamivudine Monotherapy for Chronic

Hepatitis B Virus Infection

Kiyoaki Ito,1,3 Yasuhito Tanaka,2 Etsuro Orito,3 Noboru Hirashima,1 Tatsuya

Ide,5 Teruko Hino,5 Ryukichi Kumashiro,5 Atunaga Kato,1 Haruhiko Nukaya,1

Kenji Sakakibara,1 Motokazu Mukaide,6 Hidemi Ito,4 Michio Sata,5 Ryuzo

Ueda,3 and Masashi Mizokami2

1Department of Gastroenterology, Chukyo Hospital, Departments of 2Clinical

Molecular Informative Medicine and 3Internal Medicine and Molecular Science,

Nagoya City University Graduate School of Medical Sciences, and 4Division of

Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya,

5Second Department of Internal Medicine, Kurume University School of

Medicine, Kurume, and 6SRL Inc., Komiya, Hachiouji, Tokyo, Japan

There have been reports of relapse after cessation of lamivudine monotherapy

for hepatitis B virus (HBV) infection. The aim of this study was to examine

factors that predict posttreatment relapse. Comparison 22 patients who

experienced relapse with 11 who did not after cessation of therapy showed

that predictive factors for nonrelapse were hepatitis B e antigen

seroconversion and duration of undetectable HBV DNA load (<0.7 log IU/mL),

as determined by HBV real-time detection direct testing. However, 7 of 12

patients with seroconversion experienced relapse after cessation of therapy.

Multivariate analysis revealed that the duration of an undetectable HBV DNA

load was the only independent predictive factor for nonrelapse (odds ratio,

0.50; 95% confidence interval, 0.270.9). More-prolonged lamivudine therapy

is required after seroconversion, and persistent duration of an HBV DNA

level of <0.7 log IU/mL for >6 months can more accurately aid in the

decision of when to stop lamivudine therapy.

Received 30 May 2003; accepted 30 September 2003; electronically

published 30 January 2004.

Financial support: Ministry of Health, Labor, and Welfare of Japan

(grant-in-aid H13-kanen-2).

[Guest guest]

Clinical Infectious Diseases 2004;38:000

© 2004 by the Infectious Diseases Society of America. All rights reserved.

1058-4838/2004/3804-00XX$15.00

Predicting Relapse after Cessation of Lamivudine Monotherapy for Chronic

Hepatitis B Virus Infection

Kiyoaki Ito,1,3 Yasuhito Tanaka,2 Etsuro Orito,3 Noboru Hirashima,1 Tatsuya

Ide,5 Teruko Hino,5 Ryukichi Kumashiro,5 Atunaga Kato,1 Haruhiko Nukaya,1

Kenji Sakakibara,1 Motokazu Mukaide,6 Hidemi Ito,4 Michio Sata,5 Ryuzo

Ueda,3 and Masashi Mizokami2

1Department of Gastroenterology, Chukyo Hospital, Departments of 2Clinical

Molecular Informative Medicine and 3Internal Medicine and Molecular Science,

Nagoya City University Graduate School of Medical Sciences, and 4Division of

Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya,

5Second Department of Internal Medicine, Kurume University School of

Medicine, Kurume, and 6SRL Inc., Komiya, Hachiouji, Tokyo, Japan

There have been reports of relapse after cessation of lamivudine monotherapy

for hepatitis B virus (HBV) infection. The aim of this study was to examine

factors that predict posttreatment relapse. Comparison 22 patients who

experienced relapse with 11 who did not after cessation of therapy showed

that predictive factors for nonrelapse were hepatitis B e antigen

seroconversion and duration of undetectable HBV DNA load (<0.7 log IU/mL),

as determined by HBV real-time detection direct testing. However, 7 of 12

patients with seroconversion experienced relapse after cessation of therapy.

Multivariate analysis revealed that the duration of an undetectable HBV DNA

load was the only independent predictive factor for nonrelapse (odds ratio,

0.50; 95% confidence interval, 0.270.9). More-prolonged lamivudine therapy

is required after seroconversion, and persistent duration of an HBV DNA

level of <0.7 log IU/mL for >6 months can more accurately aid in the

decision of when to stop lamivudine therapy.

Received 30 May 2003; accepted 30 September 2003; electronically

published 30 January 2004.

Financial support: Ministry of Health, Labor, and Welfare of Japan

(grant-in-aid H13-kanen-2).

[Guest guest]

Clinical Infectious Diseases 2004;38:000

© 2004 by the Infectious Diseases Society of America. All rights reserved.

1058-4838/2004/3804-00XX$15.00

Predicting Relapse after Cessation of Lamivudine Monotherapy for Chronic

Hepatitis B Virus Infection

Kiyoaki Ito,1,3 Yasuhito Tanaka,2 Etsuro Orito,3 Noboru Hirashima,1 Tatsuya

Ide,5 Teruko Hino,5 Ryukichi Kumashiro,5 Atunaga Kato,1 Haruhiko Nukaya,1

Kenji Sakakibara,1 Motokazu Mukaide,6 Hidemi Ito,4 Michio Sata,5 Ryuzo

Ueda,3 and Masashi Mizokami2

1Department of Gastroenterology, Chukyo Hospital, Departments of 2Clinical

Molecular Informative Medicine and 3Internal Medicine and Molecular Science,

Nagoya City University Graduate School of Medical Sciences, and 4Division of

Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya,

5Second Department of Internal Medicine, Kurume University School of

Medicine, Kurume, and 6SRL Inc., Komiya, Hachiouji, Tokyo, Japan

There have been reports of relapse after cessation of lamivudine monotherapy

for hepatitis B virus (HBV) infection. The aim of this study was to examine

factors that predict posttreatment relapse. Comparison 22 patients who

experienced relapse with 11 who did not after cessation of therapy showed

that predictive factors for nonrelapse were hepatitis B e antigen

seroconversion and duration of undetectable HBV DNA load (<0.7 log IU/mL),

as determined by HBV real-time detection direct testing. However, 7 of 12

patients with seroconversion experienced relapse after cessation of therapy.

Multivariate analysis revealed that the duration of an undetectable HBV DNA

load was the only independent predictive factor for nonrelapse (odds ratio,

0.50; 95% confidence interval, 0.270.9). More-prolonged lamivudine therapy

is required after seroconversion, and persistent duration of an HBV DNA

level of <0.7 log IU/mL for >6 months can more accurately aid in the

decision of when to stop lamivudine therapy.

Received 30 May 2003; accepted 30 September 2003; electronically

published 30 January 2004.

Financial support: Ministry of Health, Labor, and Welfare of Japan

(grant-in-aid H13-kanen-2).

[Guest guest]

Clinical Infectious Diseases 2004;38:000

© 2004 by the Infectious Diseases Society of America. All rights reserved.

1058-4838/2004/3804-00XX$15.00

Predicting Relapse after Cessation of Lamivudine Monotherapy for Chronic

Hepatitis B Virus Infection

Kiyoaki Ito,1,3 Yasuhito Tanaka,2 Etsuro Orito,3 Noboru Hirashima,1 Tatsuya

Ide,5 Teruko Hino,5 Ryukichi Kumashiro,5 Atunaga Kato,1 Haruhiko Nukaya,1

Kenji Sakakibara,1 Motokazu Mukaide,6 Hidemi Ito,4 Michio Sata,5 Ryuzo

Ueda,3 and Masashi Mizokami2

1Department of Gastroenterology, Chukyo Hospital, Departments of 2Clinical

Molecular Informative Medicine and 3Internal Medicine and Molecular Science,

Nagoya City University Graduate School of Medical Sciences, and 4Division of

Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya,

5Second Department of Internal Medicine, Kurume University School of

Medicine, Kurume, and 6SRL Inc., Komiya, Hachiouji, Tokyo, Japan

There have been reports of relapse after cessation of lamivudine monotherapy

for hepatitis B virus (HBV) infection. The aim of this study was to examine

factors that predict posttreatment relapse. Comparison 22 patients who

experienced relapse with 11 who did not after cessation of therapy showed

that predictive factors for nonrelapse were hepatitis B e antigen

seroconversion and duration of undetectable HBV DNA load (<0.7 log IU/mL),

as determined by HBV real-time detection direct testing. However, 7 of 12

patients with seroconversion experienced relapse after cessation of therapy.

Multivariate analysis revealed that the duration of an undetectable HBV DNA

load was the only independent predictive factor for nonrelapse (odds ratio,

0.50; 95% confidence interval, 0.270.9). More-prolonged lamivudine therapy

is required after seroconversion, and persistent duration of an HBV DNA

level of <0.7 log IU/mL for >6 months can more accurately aid in the

decision of when to stop lamivudine therapy.

Received 30 May 2003; accepted 30 September 2003; electronically

published 30 January 2004.

Financial support: Ministry of Health, Labor, and Welfare of Japan

(grant-in-aid H13-kanen-2).