Correlation of hepatitis B virus load with loss of e antigen and emerging drug-resistant variants during lamivudine therapy

It remains unclear whether sequential assessment of hepatitis B virus (HBV) load during lamivudine therapy can predict the loss of hepatitis B e antig en or emergence of drug-resistant variants. Therefore, a longitudinal study was carried out in 28 consecutive patients with chronic hepatitis B who st arted lamivudine therapy for a median of 12 months (range, 6-31). HBV DNA c opy numbers were determined at 3-month intervals. From month 6 onward, HBV viral load below the detection limit of the PCR was predictive of the loss of envelope antigen (P = 0.043). Continuously detectable HBV DNA during the first 12 months of treatment indicated emergence of drug-resistant variant s (P = 0.034). These data suggest that the goal of lamivudine therapy shoul d be complete suppression of serum HBV DNA. (C) 2001 Wiley-Liss, Inc.