Background: Three month administration of lamivudine in patients with chronic hepatitis B produces a transitory inhibition of the DNA of the hepatitis B virus (HBV).
Aim: The aim of this study was to evaluate the efficacy and safety of one year treatment with lamivudine in patients with chronic hepatitis B and liver transplantation (LTx) with recurrence of HBV infection.
Patients and methods: Sixteen patients with chronic hepatitis B, 4 patients with decompensated hepatic cirrhosis and 4 patients having undergone LTx with recurrence of HVB infection were treated with the oral administration of 100 mg/day of lamivudine for one year.
Results: At 3 months of treatment, the HBV-DNA became negative in 94% of the cases of chronic hepatitis B, in 10% of those with decompensated hepatic cirrhosis and in 100% of the cases of LTx. At one year of treatment, the HBV-DNA was negative in 81% of the chronic hepatitis B, in 100% of the decompensated cirrhotics and in 100% of the LTX cases which survived. The tolerance to treatment was excellent in all the cases. In 34% of the cases, mutations were observed in the gene of the polymerase DNA at one year of treatment.
Conclusions: Lamivudine produces intense, rapid inhibition in viral replication not only in chronic hepatitis B but also in cases of decompensated cirrhosis or recurrence following liver transplantation. Around 30% of the patients undergoing one year of treatment with lamivudine developed gene mutations of the HBV polymerase.