Predictive factors for response to Lamivudine in chronic hepatitis B
Autor(a) principal: | |
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Data de Publicação: | 2000 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/30438 |
Resumo: | BACKGROUND: Lamivudine has been shown to be an efficient drug for chronic hepatitis B (CHB) treatment. AIM: To investigate predictive factors of response, using a quantitative method with high sensitivity. METHODS: We carried out a prospective trial of lamivudine in 35 patients with CHB and evidence for viral replication, regardless to their HBeAg status. Lamivudine was given for 12 months at 300 mg daily and 150 mg thereafter. Response was considered when DNA was undetectable by PCR after 6 months of treatment. Viral replication was monitored by end-point dilution PCR. Mutation associated with resistance to lamivudine was detected by DNA sequencing in non-responder patients. RESULTS: Response was observed in 23/35 patients (65.7%) but only in 5/15 (33.3%) HBeAg positive patients. Only three pre-treatment variables were associated to low response: HBeAg (p = 0.006), high viral load (DNA-VHB >; 3 x 10(6) copies/ml) (p = 0.004) and liver HBcAg (p = 0.0028). YMDD mutations were detected in 7/11 non-responder patients. CONCLUSIONS: HBeAg positive patients with high viral load show a high risk for developing drug resistance. On the other hand, HBeAg negative patients show a good response to lamivudine even with high viremia. |
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Predictive factors for response to Lamivudine in chronic hepatitis B Fatores preditivos para resposta da Lamivudine na hepatite crônica B HepatitiLamivudHBV-b BACKGROUND: Lamivudine has been shown to be an efficient drug for chronic hepatitis B (CHB) treatment. AIM: To investigate predictive factors of response, using a quantitative method with high sensitivity. METHODS: We carried out a prospective trial of lamivudine in 35 patients with CHB and evidence for viral replication, regardless to their HBeAg status. Lamivudine was given for 12 months at 300 mg daily and 150 mg thereafter. Response was considered when DNA was undetectable by PCR after 6 months of treatment. Viral replication was monitored by end-point dilution PCR. Mutation associated with resistance to lamivudine was detected by DNA sequencing in non-responder patients. RESULTS: Response was observed in 23/35 patients (65.7%) but only in 5/15 (33.3%) HBeAg positive patients. Only three pre-treatment variables were associated to low response: HBeAg (p = 0.006), high viral load (DNA-VHB >; 3 x 10(6) copies/ml) (p = 0.004) and liver HBcAg (p = 0.0028). YMDD mutations were detected in 7/11 non-responder patients. CONCLUSIONS: HBeAg positive patients with high viral load show a high risk for developing drug resistance. On the other hand, HBeAg negative patients show a good response to lamivudine even with high viremia. INTRODUÇÃO: A Lamivudina tem-se mostrado útil no tratamento da hepatite crônica pelo vírus B (HC-VHB). OBJETIVO: Investigar os fatores preditivos da resposta à Lamivudina na HC-VHB. MATERIAL E MÉTODOS: Estudo prospectivo com Lamivudina em 35 pacientes com HC-VHB e evidência de multiplicação viral, independentemente do resultado do AgHBe. Administrou-se a Lamivudina na dose diária de 300 mg por 12 meses, seguida de 150 mg diários. Critério de resposta: DNA-VHB negativo (por técnica de PCR) aos 6 meses de tratamento. Nos pacientes não respondedores, pesquisaram-se mutações associadas com resistência à Lamivudina, através do sequenciamento do DNA viral. RESULTADOS: Observou-se resposta em 23/35 pacientes (65,7%). Dos 15 pacientes com AgHBe positivo antes do tratamento, apenas 5 (33,3%) responderam. As variáveis prévias ao tratamento que puderam prever uma má resposta foram: AgHBe positivo (p = 0,006), carga viral elevada (>; 3 x 10(6) genomas/ml) (p = 0,004) e AgHBc no tecido positivo (p = 0,0028). Mutações na região YMDD foram detectadas em 7/11 pacientes não respondedores. CONCLUSÕES: Pacientes com AgHBe positivo e com alta carga viral apresentam um alto risco de desenvolver resistência à Lamivudina. Por outro lado, pacientes com AgHBe negativo, mesmo com alta carga viral, mostraram uma boa resposta à Lamivudina. Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2000-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/30438Revista do Instituto de Medicina Tropical de São Paulo; Vol. 42 No. 4 (2000); 189-196 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 42 Núm. 4 (2000); 189-196 Revista do Instituto de Medicina Tropical de São Paulo; v. 42 n. 4 (2000); 189-196 1678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/30438/32322Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessSILVA, Luiz Caetano daFONSECA, Luís Edmundo Pinto daCARRILHO, Flair JoséALVES, Venâncio Avancini FerreiraSITNIK, RobertaPINHO, João Renato Rebello2012-07-07T09:35:17Zoai:revistas.usp.br:article/30438Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:51:12.615598Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Predictive factors for response to Lamivudine in chronic hepatitis B Fatores preditivos para resposta da Lamivudine na hepatite crônica B |
title |
Predictive factors for response to Lamivudine in chronic hepatitis B |
spellingShingle |
Predictive factors for response to Lamivudine in chronic hepatitis B SILVA, Luiz Caetano da Hepatiti Lamivud HBV- b |
title_short |
Predictive factors for response to Lamivudine in chronic hepatitis B |
title_full |
Predictive factors for response to Lamivudine in chronic hepatitis B |
title_fullStr |
Predictive factors for response to Lamivudine in chronic hepatitis B |
title_full_unstemmed |
Predictive factors for response to Lamivudine in chronic hepatitis B |
title_sort |
Predictive factors for response to Lamivudine in chronic hepatitis B |
author |
SILVA, Luiz Caetano da |
author_facet |
SILVA, Luiz Caetano da FONSECA, Luís Edmundo Pinto da CARRILHO, Flair José ALVES, Venâncio Avancini Ferreira SITNIK, Roberta PINHO, João Renato Rebello |
author_role |
author |
author2 |
FONSECA, Luís Edmundo Pinto da CARRILHO, Flair José ALVES, Venâncio Avancini Ferreira SITNIK, Roberta PINHO, João Renato Rebello |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
SILVA, Luiz Caetano da FONSECA, Luís Edmundo Pinto da CARRILHO, Flair José ALVES, Venâncio Avancini Ferreira SITNIK, Roberta PINHO, João Renato Rebello |
dc.subject.por.fl_str_mv |
Hepatiti Lamivud HBV- b |
topic |
Hepatiti Lamivud HBV- b |
description |
BACKGROUND: Lamivudine has been shown to be an efficient drug for chronic hepatitis B (CHB) treatment. AIM: To investigate predictive factors of response, using a quantitative method with high sensitivity. METHODS: We carried out a prospective trial of lamivudine in 35 patients with CHB and evidence for viral replication, regardless to their HBeAg status. Lamivudine was given for 12 months at 300 mg daily and 150 mg thereafter. Response was considered when DNA was undetectable by PCR after 6 months of treatment. Viral replication was monitored by end-point dilution PCR. Mutation associated with resistance to lamivudine was detected by DNA sequencing in non-responder patients. RESULTS: Response was observed in 23/35 patients (65.7%) but only in 5/15 (33.3%) HBeAg positive patients. Only three pre-treatment variables were associated to low response: HBeAg (p = 0.006), high viral load (DNA-VHB >; 3 x 10(6) copies/ml) (p = 0.004) and liver HBcAg (p = 0.0028). YMDD mutations were detected in 7/11 non-responder patients. CONCLUSIONS: HBeAg positive patients with high viral load show a high risk for developing drug resistance. On the other hand, HBeAg negative patients show a good response to lamivudine even with high viremia. |
publishDate |
2000 |
dc.date.none.fl_str_mv |
2000-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30438 |
url |
https://www.revistas.usp.br/rimtsp/article/view/30438 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30438/32322 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 42 No. 4 (2000); 189-196 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 42 Núm. 4 (2000); 189-196 Revista do Instituto de Medicina Tropical de São Paulo; v. 42 n. 4 (2000); 189-196 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
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