%0 Journal Article
%T High Dose of Lamivudine and Resistance in Patients with Chronic Hepatitis B
%A Hamid Ullah Wani
%A Saad Al Kaabi
%A Manik Sharma
%A Rajvir Singh
%A Anil John
%A Moutaz Derbala
%A Muneera J. Al-Mohannadi
%J Hepatitis Research and Treatment
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/615621
%X Background. Lamivudine is the most affordable drug used for chronic hepatitis B and has a high safety profile. With the daily dose of 100£¿mg there is progressive appearance of resistance to lamivudine therapy. In our study we used 150£¿mg of lamivudine daily as a standard dose which warrants further exploration for the efficacy of the drug. Aims of the Study. To assess the efficacy of lamivudine 150£¿mg daily on resistance in patients with chronic hepatitis B. Methods. This retrospective study consists of 53 patients with chronic hepatitis B treated with 150£¿mg of lamivudine daily. The biochemical and virological response to the treatment were recorded at a 1-year and 2-, 3-, 4-, and 5-year period and time of emergence of resistance to the treatment was noted. Results. The mean age of the patients was 54 years with 80% being males. The resistance to lamivudine 150£¿mg daily at 1 year and 2, 3, and 5 years was 12.5%, 22.5%, 37.5%, and 60%, respectively, which is much less compared to the standard dose of 100£¿mg of lamivudine. Conclusions. Lamivudine is safe and a higher dose of 150£¿mg daily delays the resistance in patients with chronic hepatitis B. 1. Introduction Chronic hepatitis B remains the most common serious health problem in the world, especially in the Asia Pacific region. Worldwide, there are 350 million people with chronic carrier of HBV. Treatment of HBV is relatively safe and easy compared to hepatitis C treatment, but the drug resistance is the main problem. The lamivudine and telbivudine are prone to develop resistance rapidly. Since the introduction of lamivudine, treatment of chronic hepatitis B has been characterized by a rapid increase in the number of available antiviral drugs, all belonging to the class of HBV polymerase inhibitors. Due to better tolerance and more convenient administration compared to interferon, HBV polymerase inhibitors today account for the vast majority of prescribed therapies for chronic hepatitis B in Western countries [1, 2]. However, long-term suppression of HBV is needed, particularly in HBeAg-negative patients harboring the precore mutant. Lamivudine (LAM) was the first approved HBV polymerase inhibitor. It is characterized by good clinical tolerability, moderate antiviral efficacy, and rather quick development of resistance. Approximately 20% of patients treated with LAM develop resistance to LAM by 1 year and 70% to 80% by 5 years after the start of treatment [3]. Preliminary data indicate that the development of multiple lamivudine associated mutations may even reduce the efficacy of tenofovir therapy
%U http://www.hindawi.com/journals/heprt/2014/615621/