Two-year follow-up study after treatment with lamivudine for chronic hepatitis B: seven cases reported

Recently, lamivudine has been used to treat chronic hepatitis B. The effect of lamivudine has been evaluated in short-term (6 months) follow-up studie s after treatment. Here, we report the long-term (2 years) follow-up result s of lamivudine therapy for chronic hepatitis B. The subjects were seven pa tients with chronic hepatitis B, with evidence of hepatitis B virus (HBV) r eplication. All patients were treated with 100 mg lamivudine daily for 12 m onths. The patients were monitored for up to 2 years after treatment. Serum HBV DNA by branched DNA assay of all patients became undetectable during t he therapy. In two patients, sustained suppression of serum HBV DNA was fou nd after treatment. The remaining five patients exhibited rebound of ALT (> 2 times baseline) and returned to seropositive for HBV DNA and HBeAg after lamivudine cessation. One of these five patients died of liver failure 3 mo nths after treatment. However. in two of five patients whose alanine aminot ransferase (ALT) had rebounded, HBV DNA became undetectable, and the ALT le vels markedly decreased 2 years after the end of therapy. Since the disappe arance of HBV DNA and stabilization of the ALT level were observed within t wo patients by 2 years after cessation of treatment, the patients whose ALT had rebounded should be followed up for a long-term period. To confirm the effect of lamivudine, long-term follow-up in many patients is necessary. ( C) 2000 Elsevier Science Ireland Ltd. All rights reserved.