Lamivudine Treatment Is Beneficial in Patients With Severely Decompensated Cirrhosis and Actively Replicating Hepatitis B Infection Awaiting Liver Transplantation: A Comparative Study Using A Matched, Untreated Cohort

• DOI: 10.1053/jhep.2001.26512
• Publication Date: 2002-08-25T03:46:10Z
• Authors: Francis Y. Yao; Norah A. Terrault; Chris Freise; Lin Maslow; Nathan M. Bass
• Keywords: Adult; Liver Cirrhosis; Male; Hepatitis B virus; Adolescent; Waiting Lists; Drug Resistance; Middle Aged; Hepatitis B; Virus Replication; Severity of Illness Index; Survival Analysis; Liver Transplantation; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Lamivudine; DNA, Viral; Humans; Reverse Transcriptase Inhibitors; Female; Aged

Uncontrolled studies have suggested a beneficial effect of lamivudine in patients with decompensated cirrhosis caused by replicating hepatitis B virus (HBV). We analyzed the outcome treatment 23 consecutive severely HBV–cirrhosis defined as Child–Pugh–Turcotte (CPT) score ≥10, and compared historical untreated control group matched for age, gender, baseline CPT score. Significant clinical response, decrease ≥3 points, was observed 14 (60.9%) treated versus none controls ( P < .0001). The median change scores -3.0 (range, -6 to +3) +1.0 -1 +2) = .016). Orthotopic liver transplantation (OLT) performed 34.8% (median, 3.5; range, 1–32 months), 73.9% 3.0; 1–14 months) .04). Excluding transplanted patients, there were no deaths 6 .009). Time death or OLT significantly longer than .001). Two developed resistance after 9 12 months, respectively. Our results suggest that improves hepatic function over half HBV, may confer survival advantage. However, small sample size use retrospective cohort preclude drawing definitive conclusions. Expedited remains only viable nonresponders.