|Title:||A Higher Alanine Aminotransferase Level Correlates with Earlier Hepatitis B E Antigen Seroconversion in Lamivudine-Treated Chronic Hepatitis B Patients||Authors:||TSENG, TAI-CHUNG
KAO, JIA- HORNG
|Keywords:||alanine aminotransferase;chronic hepatitis B;genotype;HBeAg seroconversion;hepatitis B virus;lamivudine;viral load||Issue Date:||2008||Journal Volume:||v.28||Journal Issue:||n.7||Start page/Pages:||1034-1041||Source:||LIVER INTERATIONAL||Abstract:||
BACKGROUND/AIMS: A pretherapy serum alanine aminotransferase (ALT) level above five times the upper limit of normal (ULN ) is known to predict hepatitis B e antigen (HBeAg) seroconversion during lamivudine therapy for chronic hepatitis B patients. However, whether an even higher pretherapy serum ALT value or other viral factors could affect treatment responses remains unclear. PATIENTS AND METHODS: A total of 253 HBeAg-positive chronic hepatitis B patients who had a pretherapy serum ALT level over five times ULN and received lamivudine for 12-18 months were retrospectively collected. Among these patients, 38% had received prior lamivudine treatment. HBeAg seroconversion was the primary endpoint of treatment. Baseline clinical and viral features were compared between responders and non- responders at the end of treatment and 6 months post- treatment. RESULTS: At the end of therapy, the overall HBeAg seroconversion rate was 33.6%. For lamivudine-naïve patients, the HBeAg seroconversion rate was 37.8%. Subgroup analysis showed that patients with pretherapy ALT levels over 10 times ULN had a significantly higher HBeAg seroconversion rate than those with a pretherapy ALT level between five and 10 times ULN at 3 months (P=0.045) and 6 months (P=0.037) of lamivudine treatment. No significant difference was found in terms of pretherapy serum ALT values , viral load and genotypes between seroconverters and non- seroconverters. CONCLUSIONS: For lamivudine- treated HBeAg- positive patients with pretherapy ALT levels over five times ULN, an even higher ALT level could predict earlier HBeAg seroconversion; however, neither ALT levels nor viral factors correlate with higher response rates after 12-18 months of treatment.
|Appears in Collections:||臨床醫學研究所|
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