Titre du document / Document title

Lamivudine treatment for chronic hepatitis B infection in children unresponsive to interferon

Auteur(s) / Author(s)

HARTMAN Corina ⁽¹⁾ ; BERKOWITZ Drora ⁽¹⁾ ; SHOUVAL Daniel ⁽²⁾ ; ESHACH-ADIV Orly ⁽¹⁾ ; HINO Bian ⁽¹⁾ ; RIMON Nurit ⁽³⁾ ; SATINGER Iehudith ⁽³⁾ ; KRA-OZ Tzipi ⁽³⁾ ; DAUDI Nily ⁽²⁾ ; SHAMIR Raanan ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Division of Pediatric Gastroenterology and Nutrition, Meyer Children's Hospital of Haifa, Rambam Medical Center, Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, ISRAEL
⁽²⁾ Liver Unit, Division of Medicine, Hadassah University Hospital, Jerusalem, ISRAEL
⁽³⁾ Laboratory of Virology, Rambam Medical Center, Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, ISRAEL

Résumé / Abstract

Backgroundlaims. Lamivudine is a potent inhibitor of hepatitis B virus (HBV) replication. This prospective open study reports the results of lamivudine treatment in children with chronic hepatitis B infection who did not respond to previous interferon treatment. Patients and methods. Lamivudine, 3 mg/kg/ day (maximum, 100 mg/day), was given for 52 weeks to 20 children and adolescents, ages 8.5 to 19 years, with chronic hepatitis B infection who had been treated with interferon 2 to 5 years earlier. We evaluated virologic and biochemical responses, the occurrence of YMDD mutants and adverse effects. Results. All children were HBV DNA⁺, hepatitis B e antigen (HBeAg)⁺/anti-hepatitis B e antibody^- at start of treatment. At the end of 1 year, HBV DNA declined by 95% in all patients, and 8 of 18 (44%) had sustained undetectable HBV DNA by hybridization assay. Median pretreatment alanine aminotransferase (ALT) ×1.5 upper limit of normal decreased to ALT x0.9 upper limit of normal after 1 year. One child became HBeAg-negative. YMDD mutants were detected in 11 of 17 (65%) children after 1 year of lamivudine treatment. Among children with YMDD mutant variants, 54% maintained normal ALT values and 45% had undetectable HBV DNA by hybridization assay. No adverse effects were observed. Conclusions. Children with chronic hepatitis B infection treated with lamivudine after failure of interferon therapy had decreased HBV replication and improved ALT values. However, lamivudine treatment resulted in an exceptionally high rate of lamivudine-resistant mutants and low HBeAg seroconversion rate.

Revue / Journal Title

The Pediatric infectious disease journal   ISSN 0891-3668   CODEN PIDJEV 

Source / Source

2003, vol. 22, n^o3, pp. 224-228 [5 page(s) (article)] (34 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott, Hagerstown, MD, ETATS-UNIS  (1987) (Revue)

Mots-clés anglais / English Keywords

Hepatic disease ; Digestive diseases ; Human ; Infection ; Viral disease ; Cytokine ; Antiviral ; Reverse transcriptase inhibitor ; Enzyme inhibitor ; Dideoxynucleoside ; Nucleosidic analog ; Toxicity ; Treatment efficiency ; Chronic ; Chemotherapy ; Child ; Treatment ; Viral hepatitis B ; Lamivudine ;

Mots-clés français / French Keywords

Foie pathologie ; Appareil digestif pathologie ; Homme ; Infection ; Virose ; Cytokine ; Antiviral ; Inhibiteur reverse transcriptase ; Inhibiteur enzyme ; Didésoxynucléoside ; Analogue nucléoside ; Toxicité ; Efficacité traitement ; Chronique ; Chimiothérapie ; Enfant ; Traitement ; Hépatite virale B ; Lamivudine ;

Mots-clés espagnols / Spanish Keywords

Hígado patología ; Aparato digestivo patología ; Hombre ; Infección ; Virosis ; Citoquina ; Antiviral ; Inhibitor reverse transcriptase ; Inhibidor enzima ; Didesoxinucleósido ; Análogo nucleósido ; Toxicidad ; Eficacia tratamiento ; Crónico ; Quimioterapia ; Niño ; Tratamiento ; Hepatitis vírica B ; Lamivudina ;

Mots-clés d'auteur / Author Keywords

Children ; chronic hepatitis B ; lamivudine ; lamivudine-resistant mutants ;

Localisation / Location

INIST-CNRS, Cote INIST : 20356, 35400010945856.0030