High risk of hepatocellular carcinoma in anti-HBe positive liver cirrhosis patients developing lamivudine resistance

[Guest guest]

Journal of Viral Hepatitis

Volume 11 Issue 5 Page 439 - September 2004

doi:10.1111/j.1365-2893.2004.00564.x

High risk of hepatocellular carcinoma in anti-HBe positive liver cirrhosis

patients developing lamivudine resistance

P. Andreone1, A. Gramenzi1, C. Cursaro1, M. Biselli1, C. Cammà2, F.

Trevisani1 and M. Bernardi1

Summary. The emergence of drug-resistant virus in hepatitis B virus patients

treated with lamivudine is well documented. However, its clinical impact in

the long-term treatment of anti-HBe positive compensated cirrhotic patients

is not well known. In this study, we treated 22 consecutive patients with

anti-HBe compensated cirrhosis with lamivudine for a median period of 42

months. All patients responded to lamivudine, but viral breakthrough

occurred in 13 patients (59%) between 9 and 42 months of therapy due to the

emergence of a mutant strain. During the follow-up, 11 developed

hepatocellular carcinoma. Of these, 10 occurred soon after the emergence of

viral resistance, generally showing aggressive behaviour, and one in the

nine long-term responder patients (P = 0.013). Lamivudine resistance was the

only independent predictor of hepatocellular carcinoma development (risk

ratio: 10.4; 95% CI: 1.3-84.9). Our study suggests that the occurrence of

lamivudine resistance increases the risk of hepatocellular carcinoma in

anti-HBe positive cirrhosis and warrants further research.

[Guest guest]

Journal of Viral Hepatitis

Volume 11 Issue 5 Page 439 - September 2004

doi:10.1111/j.1365-2893.2004.00564.x

High risk of hepatocellular carcinoma in anti-HBe positive liver cirrhosis

patients developing lamivudine resistance

P. Andreone1, A. Gramenzi1, C. Cursaro1, M. Biselli1, C. Cammà2, F.

Trevisani1 and M. Bernardi1

Summary. The emergence of drug-resistant virus in hepatitis B virus patients

treated with lamivudine is well documented. However, its clinical impact in

the long-term treatment of anti-HBe positive compensated cirrhotic patients

is not well known. In this study, we treated 22 consecutive patients with

anti-HBe compensated cirrhosis with lamivudine for a median period of 42

months. All patients responded to lamivudine, but viral breakthrough

occurred in 13 patients (59%) between 9 and 42 months of therapy due to the

emergence of a mutant strain. During the follow-up, 11 developed

hepatocellular carcinoma. Of these, 10 occurred soon after the emergence of

viral resistance, generally showing aggressive behaviour, and one in the

nine long-term responder patients (P = 0.013). Lamivudine resistance was the

only independent predictor of hepatocellular carcinoma development (risk

ratio: 10.4; 95% CI: 1.3-84.9). Our study suggests that the occurrence of

lamivudine resistance increases the risk of hepatocellular carcinoma in

anti-HBe positive cirrhosis and warrants further research.

[Guest guest]

Journal of Viral Hepatitis

Volume 11 Issue 5 Page 439 - September 2004

doi:10.1111/j.1365-2893.2004.00564.x

High risk of hepatocellular carcinoma in anti-HBe positive liver cirrhosis

patients developing lamivudine resistance

P. Andreone1, A. Gramenzi1, C. Cursaro1, M. Biselli1, C. Cammà2, F.

Trevisani1 and M. Bernardi1

Summary. The emergence of drug-resistant virus in hepatitis B virus patients

treated with lamivudine is well documented. However, its clinical impact in

the long-term treatment of anti-HBe positive compensated cirrhotic patients

is not well known. In this study, we treated 22 consecutive patients with

anti-HBe compensated cirrhosis with lamivudine for a median period of 42

months. All patients responded to lamivudine, but viral breakthrough

occurred in 13 patients (59%) between 9 and 42 months of therapy due to the

emergence of a mutant strain. During the follow-up, 11 developed

hepatocellular carcinoma. Of these, 10 occurred soon after the emergence of

viral resistance, generally showing aggressive behaviour, and one in the

nine long-term responder patients (P = 0.013). Lamivudine resistance was the

only independent predictor of hepatocellular carcinoma development (risk

ratio: 10.4; 95% CI: 1.3-84.9). Our study suggests that the occurrence of

lamivudine resistance increases the risk of hepatocellular carcinoma in

anti-HBe positive cirrhosis and warrants further research.

[Guest guest]

Journal of Viral Hepatitis

Volume 11 Issue 5 Page 439 - September 2004

doi:10.1111/j.1365-2893.2004.00564.x

High risk of hepatocellular carcinoma in anti-HBe positive liver cirrhosis

patients developing lamivudine resistance

P. Andreone1, A. Gramenzi1, C. Cursaro1, M. Biselli1, C. Cammà2, F.

Trevisani1 and M. Bernardi1

Summary. The emergence of drug-resistant virus in hepatitis B virus patients

treated with lamivudine is well documented. However, its clinical impact in

the long-term treatment of anti-HBe positive compensated cirrhotic patients

is not well known. In this study, we treated 22 consecutive patients with

anti-HBe compensated cirrhosis with lamivudine for a median period of 42

months. All patients responded to lamivudine, but viral breakthrough

occurred in 13 patients (59%) between 9 and 42 months of therapy due to the

emergence of a mutant strain. During the follow-up, 11 developed

hepatocellular carcinoma. Of these, 10 occurred soon after the emergence of

viral resistance, generally showing aggressive behaviour, and one in the

nine long-term responder patients (P = 0.013). Lamivudine resistance was the

only independent predictor of hepatocellular carcinoma development (risk

ratio: 10.4; 95% CI: 1.3-84.9). Our study suggests that the occurrence of

lamivudine resistance increases the risk of hepatocellular carcinoma in

anti-HBe positive cirrhosis and warrants further research.