Early Studying Of Lamivudine Response In E Antigen-negative Chronic Hepatitis B Patients

Objective To evaluate the effects of ALT, HBsAg and HBVDNA at the baseline,4 weeks and 12 weeks after after Lamivudine treatment on the long term(104 weeks)response in e antigen-negative chronic hepatitis B patients.Methods 127 adult e antigen-negative chronic hepatitis B patients were enrolled in this study. All Patients received treatment on LAM 100 mg/d at least 104 weeks.The liver function,Serum HBV markers and HBV viral load were regularly checked during the treatment.The effects of ALT, HBsAg and HBVDNA at the baseline,4 weeks and 12 weeks after Lamivudine treatment on the response at 104 weeks were statistically analyzed.Results The proportion of patients with serum HBVDNA＜1×103copies/ml at 104 weeks after LAM treatment was 50.0% and 86.8% in patients with baseline ALT＜5ULN and ALT≥5ULN, respectively(p<0.01). In patients with baseline HBsAg<2000COI and HBsAg > 2000COI,the proportion of patients with serum HBsAg<500COI at 104 weeks after LAM treatment was 19.1% and 17.5%, respectively(P> 0.05). the HBsAg serological conversion rates were respectively 2.1% and 2.5%, respectively(P> 0.05),the proportion of patients with serum HBVDNA＜1×103 copies/ml was 61.7% and 67.5%, respectively(P> 0.05).In patients with baseline HBVDNA< 1×106 copies/ml and HBVDNA≥1×106 copies/ml, the proportion of patients with HBVDNA＜1×103 copies/ml were statistically different at 4 weeks and 12 weeks after tratment,however, the proportion of patients with HBVDNA＜1×103 copies/ml at 104 weeks after LAM treatment was 62.7% and 67.1%, respectively (P> 0.05).In patients with HBVDNA＜1×103 copies/ml and HBVDNA≥1×103 copies/ml at 4 weeks after treatment,the proportion of patients with HBVDNA＜1×103 copies/ml at 104 weeks after LAM treatment was 70.7% and 60.9%, respectively (P> 0.05).In patients with HBVDNA＜1×103 copies/ml and HBVDNA≥1×103 copies/ml at 12 weeks after treatment, the proportion of patients with HBVDNA＜1×103 copies/ml at 104 weeks after treatment was 78.8% and 38.1%, respectively(P＜0.01).Conclusion e antigen negative chronic hepatitis B patients with baseline ALT≥5ULN and HBVDNA<1×103 copies/ml at 12 weeks after treatment have better virological response at 104 weeks after LAM treatment.The baseline HBsAg and HBVDNA load are associated with the virological response at 104 weeks after LAM treament.