Long-term Efficacy of Treatment with Lamivudine in HBeAg-Negative Patients with Decompensated Cirrhosis Due to Chronic Hepatitis B

Abstract

Background: The prognosis of patients with decompensated cirrhosis due to hepatitis B is very poor. It has been shown that lamivudine can improve liver function and delay the need for liver transplantation in HBeAg-positive patients with decompensated cirrhosis. However, information regarding long-term use of lamivudine in HBeAg-negative patients with cirrhosis is limited. The primary objective of this study was to evaluate the long-term efficacy of lamivudine in HBeAg-negative/HBeAb-positive patients with decompensated cirrhosis.

Materials and Methods: 54 consecutive HBeAg-negative/HBeAb-positive patients with decompensated cirrhosis were enrolled into this study. All patients were treated with 100 mg lamivudine per day. Significant clinical improvement was defined as a decrease of at least 2 points in Child-Pugh-Turcotte (CPT) score. Repeated-measure one-way analysis of variance was used to evaluate the effect of time interval of lamivudine treatment on different variables. Kaplan-Meier survival analysis and Mantel-Cox test were used to further analyze the data.

Results: The mean±SD age of patients was 50.6±13.2 years. There were 40 male and 14 female patients. The median follow-up was 29 (range: 6-64) months. CPT score, MELD score and blood chemistries changed significantly after 6 months of therapy. The favorable changes were continued up to 2 years. In spite of worsening after 3 years, within subject effects measured by repeated-measure ANOVA, were significant for patients who have received lamivudine for 4 years or more.

Conclusions: Long-term lamivudine therapy improves liver function in HBeAg-negative/HBeAb-positive patients with decompensated cirrhosis.