Predictors of HBeAg loss after lamivudine treatment for chronic hepatitis B

Robert P. Perrillo, Ching Lung Lai, Yun Fan Liaw, Jules L. Dienstag, Eugene R Schiff, Solko W. Schalm, E. Jenny Heathcote, Nathaniel A. Brown, Mark Atkins, Mary Woessner, Stephen D. Gardner

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Abstract

Elevated alanine transaminase (ALT) levels and low serum hepatitis B virus (HBV) DNA predict a higher likelihood of hepatitis B e antigen (HBeAg) loss in patients with chronic hepatitis B treated with interferon. Predictors of HBeAg loss in patients treated with lamivudine are not known. The objective of this analysis of 4 lamivudine-controlled Phase III trials was to determine patient-dependent or laboratory variables that predict HBeAg loss. Predictors of HBeAg loss in patients treated with interferon, lamivudine plus interferon, or placebo are also described. A total of 805 adults with chronic hepatitis B were treated either with lamivudine (n = 406), matching placebo (n = 196), interferon (n = 68), or the combination of lamivudine plus interferon (n = 135). Demographic and baseline disease characteristics were used in stepwise multivariate analyses to identify features that were predictive of lamivudine-induced HBeAg loss. HBeAg loss correlated with increased pretreatment ALT levels in all groups. The rate of HBeAg loss was highest among patients with pretreatment ALT levels greater than 5 times the upper limit of normal (ULN) and was most pronounced in the lamivudine group (56%). Multivariate modeling indicated that elevated baseline ALT levels (P < .001) and histologic activity index (HAI) score (P < .001) were important predictors of HBeAg loss in response to lamivudine. The effect of pretreatment ALT levels on HBeAg loss was similar for Asians and Caucasians. In conclusion, elevated pretreatment ALT levels and/or active histologic disease were the most important predictors of lamivudine-induced HBeAg loss. Asians and Caucasians had similar rates of response to lamivudine at comparable ALT levels.

Original languageEnglish
Pages (from-to)186-194
Number of pages9
JournalHepatology
Volume36
Issue number1
DOIs
StatePublished - Jul 9 2002

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Lamivudine
Hepatitis B e Antigens
Chronic Hepatitis B
Alanine Transaminase
Interferons
Therapeutics
Placebos
Hepatitis B virus
Multivariate Analysis
Demography

ASJC Scopus subject areas

  • Hepatology

Cite this

Perrillo, R. P., Lai, C. L., Liaw, Y. F., Dienstag, J. L., Schiff, E. R., Schalm, S. W., ... Gardner, S. D. (2002). Predictors of HBeAg loss after lamivudine treatment for chronic hepatitis B. Hepatology, 36(1), 186-194. https://doi.org/10.1053/jhep.2002.34294

Predictors of HBeAg loss after lamivudine treatment for chronic hepatitis B. / Perrillo, Robert P.; Lai, Ching Lung; Liaw, Yun Fan; Dienstag, Jules L.; Schiff, Eugene R; Schalm, Solko W.; Heathcote, E. Jenny; Brown, Nathaniel A.; Atkins, Mark; Woessner, Mary; Gardner, Stephen D.

In: Hepatology, Vol. 36, No. 1, 09.07.2002, p. 186-194.

Research output: Contribution to journalArticle

Perrillo, RP, Lai, CL, Liaw, YF, Dienstag, JL, Schiff, ER, Schalm, SW, Heathcote, EJ, Brown, NA, Atkins, M, Woessner, M & Gardner, SD 2002, 'Predictors of HBeAg loss after lamivudine treatment for chronic hepatitis B', Hepatology, vol. 36, no. 1, pp. 186-194. https://doi.org/10.1053/jhep.2002.34294
Perrillo RP, Lai CL, Liaw YF, Dienstag JL, Schiff ER, Schalm SW et al. Predictors of HBeAg loss after lamivudine treatment for chronic hepatitis B. Hepatology. 2002 Jul 9;36(1):186-194. https://doi.org/10.1053/jhep.2002.34294
Perrillo, Robert P. ; Lai, Ching Lung ; Liaw, Yun Fan ; Dienstag, Jules L. ; Schiff, Eugene R ; Schalm, Solko W. ; Heathcote, E. Jenny ; Brown, Nathaniel A. ; Atkins, Mark ; Woessner, Mary ; Gardner, Stephen D. / Predictors of HBeAg loss after lamivudine treatment for chronic hepatitis B. In: Hepatology. 2002 ; Vol. 36, No. 1. pp. 186-194.
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