| Background:Chronic hepatitis B (CHB) is one of incruble diseases, and anti-HBV treatment is very critical to improve the state of patients with CHB. Resently ten years the studys of anti-virus treatment have received enormously development, especially nucleoside analogue drugs, wihich are safe, effective, convenient, and well tolerated. Meanwhile, we know that some patients with CHB treated with nucleoside analogue drugs frome studys, show partial response(PR), even none response(NR). Even though patients who reach complete response(CR) show low rate of sustained response, hight rate of relapse after ending therapy and need to prolong the time of therapy. Prolonging the time of therapy could cause drug-resistence and mutation, and influence the efficacy of antivirus treatment. Therefore it is very important to predict the long-term effect during the early stage of therapy[1]. This study will investigate the predictors of response of CHB treated with lamivudine from two factors of virus and hosts, offer the evidences for individual therphy and furthermore research.Objective:To evaluate the efficacy and analysis the predicted factor of response to lamivudine therapy in patients with chronic hepatits BMethods:Ninety patients treatment(treated) with lamivudine for one year were analysised by retrospective study, t--he patients were grouped by the different levels of ALT, HBV DNA , HBeAg status before treatment and the degree of decreasing log10 HBV DNA at week 4th,univariate analysised the response among the groups, furthermore analysised age, gender, family history of hepatitis B among the groups.Results:There were 21 patients (21.3%) received complete response (CR),64 patients (71.1%) received partial response (PR) and 5 patients (5.6%) received non- response (NR) in 90 patients, and the rate of normalization of ALT was75.6%, the clearance of HBV DNA to undectable rate (<1×103 copies/ml) was 85.6%; In 79 patients with HBeAg-positive, the rate of HBeAg loss and seroconversion were 29.6%and 9.9%, respectively ; In patients with baseline serum ALT≥2×upper limit of normal (ULN) , the rates of complete response (CR) ,virological response(VR) and serological response(SR) were higher than with baseline serum ALT≥2×ULN (P<0.05); In patients with HBeAg-negative, the rates of CR and VR were higher than with HBeAg-positive (P<0.05); The group of HBV DNA<8log10 compared with the group of HBV DNA≥8log10 had higher rates of SR (P<0.05); The rates of VR in patients of age<40 years were 72.1% and in patients of age≥40 years were 95.5% (P<0.05); Gender and hepatitis B family history seem no effect with efficacy. During the therapy, in patients with HBV DNA<1×103 copies/ml compared with patients with HBV DNA≥1×103 copies/ml at week 4. 12 and 24, the rate of normalization of ALT had no statistical diferences, in the group of HBV DNA<1×103 copies/ml at week 4 and 24 , had high rates of the clearance of HBV DNA to undectable at week 48 (P<0.05), in the group of HBV DNA<1×103 copies/ml at week 4 and 12 , had high rates of SR at week 48 (P<0.05), In patients with the degree of decreasing HBV DNA≥2 log10 at week 4, there were 12 patients(25.5%) received CR, 43 patients(91.5%) received VR, while there were no patients received CR. only 8 patients received VR in patients with the degree of decreasing HBV DNA<2 log10 (P<0.05).Conclusion: Lamivudine was effective in patients with chronic hepatitis B. The baseline serum ALT, HBV DNA, HBeAg status, the degree of decreasing log10 HBV DNA at week 4th and age may predict the efficacy of lamivudine. The degree of decreasing HBV DNA≥2 log10 at week 4 was significantly predictive of response at one years.
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