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Management of Decompensated Cirrhosis due to HbeAg-negative chronic HBV infection with Lamivudine monotherapy

Suhail Ahmed Almani, Abdul Sattar Memon, Jawed Memon, Allah Bachayo Memon, Iqbal Memon..

OBJECTIVE: To evaluate the efficacy of long-term lamivudine monotherapy in patients with decompensated cirrhosis due to HbeAg-negative/HBV-DNA positive. DESIGN: Case - control study. SETTING: Departments of Medicine and Surgery, Liaquat University Hospital, Jamshoro, and Isra University Hospital Hyderabad, from March 2000 to June 2003. PATIENTS AND METHODS: We analyzed the clinical course and outcome of lamivudine treatment in 30 consecutive cirrhotics and compared with 30 HBV untreated HbeAg-negative controls. RESULTS: Significant clinical improvement, defined as a reduction of at least two points in Child-Pugh score was observed in 23 of the 30 treated patients (76.6%) versus none of the 30 patients in the control group (p< 0.0001) after a mean follow-up of 10.6 ± 2.1 (±SD) months. There were 10 deaths in the treated group versus 24 in the control group (p= 0.07). Patients with clinical improvement had better survival than patients with no improvement (p=0.04). CONCLUSION: Lamivudine monotherapy significantly improves liver function in HbeAg-negative decompensated cirrhosis.

Key words: Lamivudine. Liver Cirrhosis. Hepatitis B, Chronic. Hepatitis B e Antigens. Antiviral Agents. Reverse Transcriptase Inhibitors. Hepatitis B virus. Hepatitis B. Drug Resistance, Viral.

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