Predictive factors for response to Lamivudine in chronic hepatitis B

Detalhes bibliográficos
Autor(a) principal: SILVA, Luiz Caetano da
Data de Publicação: 2000
Outros Autores: FONSECA, Luís Edmundo Pinto da, CARRILHO, Flair José, ALVES, Venâncio Avancini Ferreira, SITNIK, Roberta, PINHO, João Renato Rebello
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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spelling 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
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instname:Instituto de Medicina Tropical (IMT)
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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)
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