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KMID : 0816120130160020080
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Korean Journal of Pediatric Gastroenterolology and Nutrition
2013 Volume.16 No. 2 p.80 ~ p.88
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Current Role of Lamivudine Regarding Therapeutic Response and Resistance in Children with Chronic Hepatitis B
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Hong Suk-Jin
Kim Yeo-Hyang
Choe Byung-Ho
Park Hyo-Jung
Tak Won-Young
Kweon Young-Oh
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Abstract
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Purpose: To identify the predictive factors of long-term therapeutic response or resistance to lamivudine treatment in children and adolescents with chronic hepatitis B.
Methods: Eighty one children and adolescents with chronic hepatitis B were included, who received lamivudine treatment for at least 6 months. Their condition was monitored for at least 12 months (12-88 months) thereafter. Twenty one (25.9%) were preschool children (age≤6). For patients who had developed HBeAg seroconversion or breakthrough, univariate and multivariate analyses were used to identify the effects of age, gender, pretreatment alanine aminotransferase (ALT) and hepatitis B virus DNA levels.
Results: HBeAg seroconversion occurred in 49 (60.5%) of the 81 patients after the initiation of the lamivudine therapy. In 65 patients whom were monitored for over 24 months, the seroconversion rate was significantly higher in younger patients (p=0.040), especially in those patients of preschool age (age≤6, p=0.031). The seroconversion rate was significantly higher in higher pretreatment ALT (p=0.003). The breakthrough occurred in 21 (25.9%) of the 81. The breakthrough rate was lower in younger aged patients (age≤6), and with higher pretreatment ALT levels, but no significant difference.
Conclusion: Younger age is a good predictor of HBeAg seroconversion in children with
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KEYWORD
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Chronic hepatitis, Child, Lamivudine, Seroconversion, Therapeutics
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