Efficacy of lamivudine in patients with hepatitis B virus pre-core mutant infection pre- and post- liver transplantation

Ben‐Ari, Ziv; Zemel, Romy; Kazatsker, A.; Fraser, Gilles; Tur-Kaspa, R

doi:10.1016/s0168-8278(98)80798-8

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“…Die bisher vorliegenden Daten deuten allerdings darauf hin, daß Lamivudine eine schnellere und ausgeprägtere Hemmung der HBV-Replikation induziert als Famciclovir. Die Ansprechraten im Hinblick auf eine Negativierung der HBV-DNA betrugen unter Lamivudine 100% (34,35) im Vergleich zu 25-82% bei Famciclovir (36)(37)(38). Ferner ist zu bedenken, daß Famciclovir nicht zur Therapie der chronischen HBV-Infektion zugelassen ist.…”

Section: T H E Rapie Der Ch Ro N I S Chen Hepatitis B Bei Pa T I E N unclassified

Neue Entwicklungen in der Therapie der chronischen Hepatitis B. Wann sind Nukleosidanaloga indiziert?

Petry¹,

Erhardt²,

Heintges³

et al. 2000

Z Gastroenterol

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Nucleoside analogues are promising agents for the treatment of chronic hepatitis B infection (HBV-DNA-positive by hybridization assay). The drug being studied most intensively is Lamivudine (Zeffix) which has recently been approved in Germany. When given orally once daily (100 mg) Lamivudine is well-tolerated and suppresses HBV-DNA to undetectable levels in the majority of patients. Since relapse is frequent when medication is stopped long-term treatment (at least until seroconversion of HBeAg) is warranted. Indications for lamivudine monotherapy are patients with chronic hepatitis B in which interferon (IFN) is contraindicated or patients who did not respond to a previous course of interferon. Further indications are the HBV-DNA-positive cirrhosis prior to liver transplantation (OLT) and the HBV-reinfection after OLT. The main problem of long-term monotherapy with lamivudine is viral resistance. The clinical impact of the resistant mutants is often not clear. Withdrawal or even continuation of the medication may be acceptable approaches. Other nucleoside analogues like Entecavir or Adefovir are currently being tested in clinical studies. Famciclovir was investigated preferably in patients with decompensated liver disease or HBV-reinfection after OLT. Because of conflicting results the drug should only be used under study conditions. In IFN-naive patients with chronic hepatitis B (and compensated liver disease) alpha-interferon is still the first-line therapy. With a standard course of interferon 30-40% of the patients become seronegative for HBeAg as compared with 16-17% when treated with lamivudine for twelve months. Combination of lamivudine and interferon is not more effective than IFN alone. In the future combined antiviral treatment is likely to replace monotherapy.

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Section: T H E Rapie Der Ch Ro N I S Chen Hepatitis B Bei Pa T I E N unclassified

Neue Entwicklungen in der Therapie der chronischen Hepatitis B. Wann sind Nukleosidanaloga indiziert?

Petry¹,

Erhardt²,

Heintges³

et al. 2000

Z Gastroenterol

View full text Add to dashboard Cite

show abstract

Efficacy of lamivudine in patients with hepatitis B virus pre-core mutant infection pre- and post- liver transplantation

Cited by 1 publication

References 0 publications

Neue Entwicklungen in der Therapie der chronischen Hepatitis B. Wann sind Nukleosidanaloga indiziert?

Neue Entwicklungen in der Therapie der chronischen Hepatitis B. Wann sind Nukleosidanaloga indiziert?

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