The Effectiveness of Lamivudine Treatment in Cirrhotic Patients with HBV Precore Mutations: A Prospective, Open-Label Study |
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Authors: | Cengiz Bolukbas MD Fusun Filiz Bolukbas MD Tulin Kendir MD Nihat Akbayir MD Ali Tuzun Ince MD Evren Abut MD Mehmet Horoz MD Ali Remzi Dalay MD Mehmet Haci Sokmen MD Oya Ovunc MD |
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Affiliation: | (1) Department of Internal Medicine, Division of Gastroenterology, Harran University, Sanliurfa;(2) Department of Internal Medicine, Harran University, Sanliurfa;(3) Gastroenterology Clinic, Haydarpasa Numune Training and Research Hospital, Istanbul;(4) Gastroenterology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey;(5) Yenisehir Mah. 4. sokak, Altiparmak Apt. Kat:2 Daire:3, 63100 Sanliurfa, Turkey |
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Abstract: | In this study, the effect of lamivudine therapy on viral suppression, Child-Pugh score, and survival was assessed in patients with decompensated cirrhosis due to precore mutant hepatitis B virus and the results were compared with those for nonreplicative cirrhotic patients. Twenty-three replicative patients who received lamivudine and 15 nonreplicative patients were included and followed up for an average of 23.7 ± 13.4 months. At baseline, there were no significant differences between the groups with regard to clinical and biochemical parameters or Child-Pugh scores, except for serum alanine aminotransferase levels (P < 0.05) and quantitative hepatitis B virus DNA measurements (P < 0.001). Compared to baseline, there was no significant difference in Child-Pugh score in the lamivudine group at the last visit (P = 0.202), whereas a marked increase was observed in nonreplicative patients (P = 0.002). Mortality rates in the lamivudine and nonreplicative groups were 17.43% and 13.3%, respectively (P = 0.556), and there was no difference in survival analysis (P = 0.809). Lamivudine therapy stabilizing clinical situation in decompensated cirrhotics with precore mutation makes the natural history of the disease equal with nonreplicative decompensated cirrhotics or even provides some advantages over them. |
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Keywords: | cirrhosis hepatitis B virus HBV DNA viral replication precore mutant Child-Pugh score survival liver transplantation |
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