Resumen

Background: To investigate the effects of prolonged Lamivudine (LAM) treatment in chronic hepatitis B-infected children who were treated with combination therapy and continued with LAM. Methodology: Thirty-seven patients were included in the study. All patients were treated with Interferon alpha (IFN-) and LAM for 6 months simultaneously. Thereafter, randomly chosen 14 of the 37 patients received LAM alone for 18 months (group 1), 11 for 30 months (group 2) and 12 for 42 months (group 3). Patients were evaluated with complete blood count, ALT values and serological markers of hepatitis B virus, periodically. Follow-up was at 48 months. End of therapy response was defined as ALT normalization and HBV-DNA clearance and e-seroconversion. Breakthrough infection was determined as re-emergence of HBV-DNA in serum after its clearance. The response rates and side effects were examined on prolonged LAM therapy. Results: Mean age of the cases was 13.1 + 3.7 years and 27 of the patients (73%) were male. HBV-DNA levels were decreased in groups 1 and 2 after combination therapy, but not in group 3. When we compared end of combination therapy response to HBV-DNA levels at the end of 48 months follow-up, there was a significant increase of HBV-DNA level in group 1 (p = 0.012). In group 2, end of 48 months HBV-DNA was significantly decreased from pretreatment levels. In groups 1 and 2, combination therapy significantly reduced mean ALT values (p = 0.004, p = 0.003, respectively). HBeAg seroconversion rates were significantly increased in groups 1 and 2 compared to group 3. The breakthrough infection rate was highest in group 3 (p>0.05). Conclusion: Chronic hepatitis B virus-infected children showed increased breakthrough incidence and did not induce complete response with the prolongation of LAM monotherapy, especially when treated with LAM for 42 months following the combination therapy.

Palabras clave: Hepatitis B treatment prolonged lamivudine children.

2007-11-06   |   741 visitas   |   Evalua este artículo 0 valoraciones

Vol. 1 Núm.2. Octubre 2007 Pags. 158-163 J Infect Developing Countries 2007; 1(2)