Research On The Use Of Lamivudine To Cure Children With Chronic Hepatitis B

Purpose: By the research on the influence of lamivudine on the growth of Children with chronic hepatitis B, it studies its security and curing effect by analysing liver function, markers of hepatitis B. It intends to provide a reference for the use of lamivudine of children with chronic hepatitis B in China.Method: All the patients were the clinic and hospital patients in the hospital where the author works from August 2006 to August 2009.1. It randomly selected 33 children patients with chronic hepatitis B willing to antiviral therapy as therapy group, the largest 14 year old and the youngest 2 years old.They were given lamivudine 3mg/kg/d, no more than 100mg/d, and licorice diammonium and other routine therapy if needed. By regular follow-up, it collected data of children's growth, liver function, markers of hepatitis B before the curative treatment and 3 months, 6 months, 9 months and one year after the treatment.2. It randomly selected 30 children patients with chronic hepatitis B not willing to antiviral therapy as children comparison group,the largest 14 year old, the youngest 4 years old, by routine therapy such as glycyrrhizic acid, diammonium. By regular follow-up, it collected data as that of the therapy group.3. It randomly selected 31 adult patients with chronic hepatitis B willing to antiviral therapy as adult comparison group, the largest 56 year old, the youngest 17 years old, They were given lamivudine 100mg per day. By regular follow-up, it collected data as that of the therapy group.Three groups of patients were not detected YMDD strain before therapy treatment.They were diagnosed as HBeAg-positive chronic hepatitis patients in accordance with The Guideline of Prevention and Diagnosis of Chronic Hepatitis B in 2005.4. Data Analysis: respectively parameter t-test, X2 test.Result:1. There is no serious adverse reactions in the therapy group after one year treatment.Children's Wechsler Intelligence Scale scores, white blood cells, kidney function Cr, t values of the increase of height and weight respectively are: -0.978 , -0.74,1.24,0.788,0.703. P values> 0.05 in the therapy group and the children comparison group. The results show no statistical difference between the two groups and children's growth is not affected.2. The rate of ALT normalization, negative rate of HBVDNA, seroconversion rate of HBeAg/HBeAb, mutation rate X2 of YMDD respectively are: 0.11,0.11,0.799,1.45 P values> 0.05 in the therapy group and the adult comparison group.The results show no statistical difference and same curing effect between the two groups.3. The rates of ALT normalization, seroconversion rate X2 of HBeAg/HBeAb, respectively are : 6.63, 5.16, p P values <0.05 in the therapy group and the children comparison group after one year treatment. It shows statistical difference between the two groups. Negative rate of HBVDNA in the therapy group is 77.42%, while 0% in the children comparison group. There is obvious difference of curing effect between the two groups. YMDD mutation in the therapy group is 6.45%, while 0% in the children comparison group.The difference is obvious.4. In the therapy group, two cases show HBsAg negative, one case HBsAb, but it does not exist in the children comparison group.Conclusion:1. It is safe and effective to use lamivudine for curing children with chronic hepatitis B. In the therapy group, there is no serious adverse events and children's growth is not affected.2. The curing effect of children with chronic hepatitis B using lamivudine antiviral therapy is similar to that of adults. There is no statistical difference in rate of aminotransferase normalization, seroconversion rates, negative rate of HBVDNA, mutation rate of YMDD after one year treatment.3. There is no statistical difference in the rate of ALT normalization, conversion rate of serum, negative rate of HBVDNA, mutation rate of YMDD between the therapy group and the comparison group.4. The rate of disappear of HBsAg or the incidence of seroconversion in children with chronic hepatitis B using lamivudine antiviral therapy may be more common than that in adults. It needs further study.