A higher alanine aminotransferase level correlates with earlier hepatitis B e antigen seroconversion in lamivudine-treated chronic hepatitis B patients
Journal
Liver International
Journal Volume
28
Journal Issue
7
Pages
1034-1041
Date Issued
2008
Author(s)
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-na?ve 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. ? Journal compilation ? 2008 Blackwell Munksgaard.
Subjects
[SDGs]SDG3
SDGs
Other Subjects
alanine aminotransferase; hepatitis B(e) antigen; lamivudine; adult; aged; alanine aminotransferase blood level; article; chronic hepatitis; clinical feature; controlled study; correlation analysis; drug efficacy; drug response; female; genotype; hepatitis B; Hepatitis B virus; human; major clinical study; male; outcome assessment; prediction; reference value; retrospective study; seroconversion; treatment duration; virus load
Publisher
Blackwell Publishing Ltd
Type
journal article