Course of virologic breakthroughs under long-term lamivudine in HBeAg-negative precore mutant HBV liver disease

摘要: We studied the course of virologic breakthroughs detected by a quantitative polymerase chain reaction (PCR) assay in 32 78 patients with hepatitis B e antigen (HBeAg)-negative precore mutant virus (HBV) chronic liver disease under long-term lamivudine monotherapy. Serum HBV DNA levels were measured every 3 months and on biochemical breakthrough. YMDD mutants 30 breakthroughs. Among these patients, remission rate was 44% at 6 months, 21% 12 0% 24 after onset Development associated significant increase serum levels, which exceeded 100,000 copies/mL 19 20 (95%) only 1 8 (12.5%) remaining for least breakthrough (P <.001). Alanine aminotransferase (ALT) level peaked within 0 to decreased but remained abnormal all 2 patients. Follow-up histologic lesions did not differ from baseline findings, although they significantly improved remission. In conclusion, frequent emergence viral resistance monotherapy HBeAg-negative is followed increasing viremia culminating development most cases. ALT activity peaks close breakthrough, decreasing thereafter persistently fluctuating levels.