Long-term lamivudine therapy for chronic hepatitis B infection in children unresponsive to interferon
| Autor: | Corina Hartman, B Hino, Orly Eshach-Adiv, Nurit Rimon, Drora Berkowitz, Tzipi Kra-Oz, Iehudith Satinger, Raanan Shamir |
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| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Hepatitis B virus Time Factors Adolescent Antiviral Agents Treatment Refusal Hepatitis B Chronic Internal medicine Medicine Humans Hepatitis B e Antigens Prospective Studies Treatment Failure Seroconversion Adverse effect Child Subclinical infection Hepatitis Reverse-transcriptase inhibitor business.industry Gastroenterology Lamivudine Alanine Transaminase Hepatitis B Viral Load medicine.disease Treatment Outcome Pediatrics Perinatology and Child Health Immunology Viral disease Interferons business medicine.drug Follow-Up Studies |
| Zdroj: | Journal of pediatric gastroenterology and nutrition. 43(4) |
| ISSN: | 1536-4801 |
| Popis: | Objectives: Prolonged lamivudine treatment in adults has been shown to improve hepatitis B e (HBe) seroconversion rates in patients with chronic hepatitis B. This prospective open study reports the results of prolonged lamivudine treatment in a group of children with chronic hepatitis B. Patients and Methods: Twenty-two children and adolescents age 13.2 years (range, 9.5-18 years), who have been treated with lamivudine for 1 year, continued treatment with lamivudine (3 mg/kg/day, up to 100 mg/d) as long as there was evidence of continued biochemical and virological benefit compared with baseline. We evaluated virological and biochemical responses, the occurrence of YMDD mutants and adverse effects during 4 years of follow-up. Results: After 4 years on lamivudine, only 4 patients (18%) underwent HBe seroconversion. In addition, in 3 patients (13%), the treatment was stopped when lamivudine's lack of efficacy became evident. During the 4-year study period, we recorded a continuing decline in the participants' number, mostly because of lack of compliance with treatment (9/22, 41%). Only 5 children were still receiving lamivudine and showing benefit after 4 years. In 2 children, treatment termination and YMDD mutant emergence were associated with hepatitis flare. Besides subclinical elevation of creatine phosphokinase, no other adverse events were recorded during the study period. Conclusions: Four years after starting lamivudine treatment, most children from this study were off lamivudine, mainly because of lack of compliance and poor HBe seroconversion. These findings suggest that continuing treatment with lamivudine for undefined periods is hard to implement and does not improve HBe seroconversion. |
| Databáze: | OpenAIRE |
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