Original ArticlesProlonged Lamivudine Treatment in Patients with Chronic Active Anti-HBe–Positive HepatitisScotto, Gaetano1 *; Palumbo, Emilio1; Fazio, Vincenza2; Cibelli, Donatella Concetta1; Saracino, Annalisa1; Tartaglia, Alessandra1; Angarano, Gioacchino1 Author Information 1Infectious Diseases Unit, University of Foggia, Foggia, Italy 2Laboratory of Clinical Chemistry, Foggia Hospital, Foggia, Italy *Address for correspondence: Via Mastelloni, 17, 71100 Foggia, Italy. E-mail: [email protected] American Journal of Therapeutics 13(3):p 218-222, May 2006. | DOI: 10.1097/01.mjt.0000158341.93235.5e Buy Metrics Abstract The efficacy of lamivudine (LAM) at 100 mg/d for 1 year in normalizing serum ALT levels and suppressing HBV DNA has been demonstrated in many studies. However, frequent relapses make long-term results modest. In the present study, we evaluated the efficacy of LAM administered for 3 years in patients with chronic active anti-HBe–positive hepatitis. Thirty-four patients with chronic active anti-HBe–positive hepatitis were treated with LAM (100 mg) once daily for 3 years. Before treatment, all patients demonstrated serum ALT levels >2 times normal levels for >6 months and HBV DNA positivity >5 pg/mL as determined by the sandwich hybridization test for nucleic acid. Both ALT and HBV DNA were monitored during therapy. After 12 months of therapy, 24 of 34 patients (70.6%) showed evidence of HBV DNA clearance and normal ALT levels; 22 of 34 (64.7%) and 19 of 34 (55.8%) patients maintained a complete response after 2 and 3 years of therapy, respectively. The long-term LAM therapy (>1 year) was not associated with an increase in the response of intially nonresponder patients. The YMDD variant emerged in 17.6% of patients in the first year, in 35.2% during the second year, and 52.9% during the third year of treatment. LAM was well tolerated during the 3-year therapy in all patients. Patients with chronic active anti-HBe–positive hepatitis demonstrated that the LAM response rate tends to decrease over time due to the emergence of YMDD variants. © 2006 Lippincott Williams & Wilkins, Inc.