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High rates of progressive hepatic functional deterioration whether lamivudine therapy is continued or discontinued after emergence of a lamivudine-resistant mutant: a prospective randomized controlled study
DC Field | Value | Language |
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dc.contributor.author | Kim, Yoon Jun | - |
dc.contributor.author | Kim, Byeong Gwan | - |
dc.contributor.author | Jung, Jun-Oh | - |
dc.contributor.author | Yoon, Jung-Hwan | - |
dc.contributor.author | Lee, Hyo-Suk | - |
dc.date.accessioned | 2010-01-08T08:38:34Z | - |
dc.date.available | 2010-01-08T08:38:34Z | - |
dc.date.issued | 2006-05-16 | - |
dc.identifier.citation | J Gastroenterol. 2006 Mar;41(3):240-9. | en |
dc.identifier.issn | 0944-1174 (Print) | - |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16699858 | - |
dc.identifier.uri | https://hdl.handle.net/10371/29095 | - |
dc.description.abstract | BACKGROUND: The management of patients with lamivudine-resistant mutants remains challenging, and no clear evidence has been presented concerning the discontinuation of lamivudine. METHODS: Seventy-four patients with lamivudine-resistant mutants were prospectively enrolled and randomized; 37 patients continued (group A) and 37 patients discontinued lamivudine therapy (group B). The median follow-up was 20 months. RESULTS: Serum albumin levels were reduced and prothrombin time was prolonged in both groups versus baseline (P = 0.015 and 0.045, respectively). Four patients in group A (10.8%) and six in group B (16.2%) experienced hepatitis flare, but the difference was not significant (P > 0.05). Multivariate analyses identified a younger age as a risk factor for hepatitis flare (P = 0.021). Seven (18.9%) decompensations occurred in group A and five (13.5%) in group B, which was not a significant difference (P > 0.05). Multivariate analyses revealed higher alanine aminotransferase and a lower platelet count as risk factors for hepatic decompensation (P = 0.001 and 0.001, respectively). The patients whose platelet count was <65 000/microl experienced hepatic decompensations more frequently (50%) than those with platelet counts >65 000/microl (13.2%) during follow-up (P = 0.05). CONCLUSIONS: The clinical course of group B was not significantly different from that of group A. Therefore, the discontinuation of lamivudine may be a feasible option when other antiviral agents active against lamivudine-resistant mutants are unavailable. | en |
dc.language.iso | en | en |
dc.publisher | Springer Verlag | en |
dc.subject | Adolescent | en |
dc.subject | Adult | en |
dc.subject | Aged | en |
dc.subject | Alanine Transaminase/blood/drug effects | en |
dc.subject | Bilirubin/blood | en |
dc.subject | Biological Markers/blood | en |
dc.subject | DNA, Viral/blood/drug effects | en |
dc.subject | Disease Progression | en |
dc.subject | Drug Resistance, Viral/*drug effects | en |
dc.subject | Female | en |
dc.subject | Follow-Up Studies | en |
dc.subject | Hepatitis B e Antigens/blood/drug effects | en |
dc.subject | Hepatitis B virus/drug effects/metabolism | en |
dc.subject | Hepatitis B, Chronic/blood/drug therapy/epidemiology/virology | en |
dc.subject | Humans | en |
dc.subject | Korea/epidemiology | en |
dc.subject | Lamivudine/adverse effects/*therapeutic use | en |
dc.subject | Liver Failure/blood/*epidemiology/*physiopathology | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Multivariate Analysis | en |
dc.subject | Mutation/*drug effects | en |
dc.subject | Platelet Count | en |
dc.subject | Predictive Value of Tests | en |
dc.subject | Prospective Studies | en |
dc.subject | Prothrombin Time | en |
dc.subject | Reverse Transcriptase Inhibitors/adverse effects/*therapeutic use | en |
dc.subject | Risk Factors | en |
dc.subject | Serum Albumin/drug effects/metabolism | en |
dc.title | High rates of progressive hepatic functional deterioration whether lamivudine therapy is continued or discontinued after emergence of a lamivudine-resistant mutant: a prospective randomized controlled study | en |
dc.type | Article | en |
dc.contributor.AlternativeAuthor | 김윤준 | - |
dc.contributor.AlternativeAuthor | 김병관 | - |
dc.contributor.AlternativeAuthor | 정준오 | - |
dc.contributor.AlternativeAuthor | 윤정환 | - |
dc.contributor.AlternativeAuthor | 이효석 | - |
dc.identifier.doi | 10.1007/s00535-005-1750-5 | - |
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