Antiviral drugs in chronic hepatitis B: review and meta-analysis

Malaguarnera, M; Restuccia, Salvatore; Ferlito, L.; Mazzoleni, Giorgia; Giugno, I; Pistone, Giovanni

doi:10.5414/cpp39004

Cited by 7 publications

(4 citation statements)

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“…Increasing studies confirmed that resistance mutation of reverse transcriptase domain of HBV DNA polymerase is the main cause of compromised long-term efficacy of nucleos(t)ide analogs in CHB patients [20][21]. Therefore, predicting the long-term efficacy of nucleos(t)ide analogs is equivalent to predicting presence of a resistance mutation.…”

Section: Discussionmentioning

confidence: 99%

PP-111 Optimal threshold: baseline serum hepatitis B virus DNA and alanine transaminase levels predict the 2-year on-treatment virological response to lamivudine

Yan¹,

Xie²,

Wang³

et al. 2010

International Journal of Infectious Diseases

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BackgroundHBV is still a worldwide health problem. Annually about 0.5-1.2 million patients die of HBV-related diseases such as liver cirrhosis and hepatocellular carcinoma. Lamivudine (LAM) is the first nucleoside analog used in the treatment of chronic hepatitis B. As LAM has been clinically used for a long time, increasing clinical experience has been achieved showing that the resistance mutation rate is relatively high. Numerous studies have also focused on the predictive factors of long-term efficacy of LAM treatment.ObjectivesTo determine the optimal cutoff values of baseline hepatitis B virus (HBV) DNA and alanine transaminase (ALT) levels as predictors for the long-term efficacy of LAM treatment in patients with chronic hepatitis B.Patients and MethodsA total of 163 HBeAg-positive chronic hepatitis B patients receiving LAM treatment were recruited into the present study. Logistic regression analysis was performed to find out the independent predictors of 2-year on-treatment virological response among the baseline parameters. The receiver operating characteristic (ROC) curve was used to evaluate the optimal cutoff values of these independent predictors. The accuracy of the prediction was assessed using the area under curve (AUC) and optimal cutoff values were determined through maximizing the Youden's index.ResultsAfter 2 years of LAM treatment, undetectable HBV DNA was maintained in 114 (69.9%) patients. LAM-related resistance mutation (YMDD mutation) was detected in 45 (27.6%) patients. Logistic regression analysis indicated that the baseline ALT and HBV DNA levels were the independent predictors of the efficacy. ROC curve analysis suggested the integration parameter derived from the baseline ALT and HBV DNA levels had the maximal predictive value for a 2-year on-treatment virological response. The optimal cutoff values of ALT and HBV DNA were 220 IU/L and 8.2 log10 copies/mL, respectively.ConclusionsThe incidence of LAM-resistant mutations in HBeAg-positive chronic hepatitis B patients may be significantly reduced and long-term efficacy improved when the baseline ALT was greater than 220 IU/L and HBV DNA was less than 8.2 log10 copies/mL.

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Section: Discussionmentioning

confidence: 99%

PP-111 Optimal threshold: baseline serum hepatitis B virus DNA and alanine transaminase levels predict the 2-year on-treatment virological response to lamivudine

Yan¹,

Xie²,

Wang³

et al. 2010

International Journal of Infectious Diseases

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“…The development of CHB infection may lead to extensive liver damage culminating in cirrhosis and hepatocellular carcinoma in 20-30% of such cases [13,14]. Recently developed novel therapeutic regimes based on inhibiting viral replication via the use of nucleoside analogues have been shown to induce improvements in hepatic histology, decreases in viral replication rates, normalization of liver function tests, and increased seroconversion of HBeAg [15][16][17]. There is, however, a lack of information regarding the effect of such therapy on new serum markers of hepatocyte damage, such as (GST.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of α-Glutathione-S-Transferase as a Biomarker of Lamivudine Therapy for Chronic Hepatitis B

Maxwell¹,

Flisiak

2006

Dig Dis Sci

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Hepatic damage associated with chronic hepatitis B (CHB) relies on measurement of serum transaminases and asssessment of hepatic histology. We determined if serum hepatic function tests, including alpha-glutathione-S-transferase ((GST), were of value in monitoring or predicting the effect of lamivudine therapy for CHB. Thirty-nine patients received orally 100 mg of lamivudine daily for 48 weeks. Blood samples were obtained at baseline and at 24 and 48 weeks. At the end of the treatment period the patients were then divided into four groups according to the pattern of HBs and HBe antigens. At baseline and at 24 weeks ALT, AST, and (GST had lower values in the complete response compared to the complete failure groups. Using ROC analysis, only ALT at 24 weeks (area under the curve = 0.803) had significant diagnostic ability in detecting responders. These results reaffirm the value of measuring serum ALT as an indicator of treatment response and provide information on the potential use of (GST as an additional prognostic biomarker in this patient group.

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“…1: Woche -2). Unter Behandlung mit Lamivudin, für das ein antiviraler Effekt gut belegt ist [12,13], werden bei 10 % der Patienten Flares der Hepatitis mit Erhöhungen der Transaminasen auf Werte der 3-bis 10fachen Norm beobachtet. Diese treten gewöhnlich in den ersten Wochen der Therapie auf [4].…”

Section: Diskussionunclassified

Schwere Exazerbation einer chronischen Hepatitis B unter Therapie mit Kortikosteroiden und Lamivudin und erfolgreiche Kurzzeit-Kombinationstherapie mit Interferon-β und -γ

Musch

Malek²,

Chrissafidou³

2003

Z Gastroenterol

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Following an acute episode of undifferentiated collagenosis/autoimmune disease with joint pain, a 50-year-old female patient with known long-standing chronic hepatitis B was treated orally with corticosteroids (30 mg prednisolone in decreasing doses over a period of six months). During this treatment, exacerbation of hepatitis B and massive flare-up under simultaneous treatment with lamivudine occurred (GOT 530 U/L, GPT 791 U/L). Serology was positive for HBs-Ag and anti-HBc-lgM. HBV-DNA titer was > 400,000 copies/ml in polymerase chain reaction. Considering the increased risk of reactivation of autoimmune phenomena during a six months therapy with interferon-alpha, an intensive combination therapy with interferon-beta and -gamma (2 weeks: 1 x 3 MIU nIFN-beta Fiblaferon i.v.; 3 weeks: 1 x 3 MIU nIFN-beta i.v. plus 1 x 50 microg rIFN-gamma Imukine) was carried out over five weeks. After two months this resulted in a complete viral and biochemical response. During an observation period of twelve months no reactivation of the autoimmune disease occurred.

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Antiviral drugs in chronic hepatitis B: review and meta-analysis

Cited by 7 publications

References 0 publications

PP-111 Optimal threshold: baseline serum hepatitis B virus DNA and alanine transaminase levels predict the 2-year on-treatment virological response to lamivudine

PP-111 Optimal threshold: baseline serum hepatitis B virus DNA and alanine transaminase levels predict the 2-year on-treatment virological response to lamivudine

Evaluation of α-Glutathione-S-Transferase as a Biomarker of Lamivudine Therapy for Chronic Hepatitis B

Schwere Exazerbation einer chronischen Hepatitis B unter Therapie mit Kortikosteroiden und Lamivudin und erfolgreiche Kurzzeit-Kombinationstherapie mit Interferon-β und -γ

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