Objective To evaluate the optimum treatment outcome in chronic HBV patients treated with Lamivudine.Meth-ods A total of 216, 114 chronic hepatitis B and 94 cirrhotic, patients were included in the study.The patients were divid-ed into HBeAg positive group (122 patients) and HBeAg negative group (94 patients) .All patients were treated with Lamivudine 100mg once daily for 36-84 months (61 ± 9.8 months on average) .Liver function tests, HBVDNA level, HBeAg sero conversion, serological markers and genetic variations were analyzed.Results No viral breakthrough and viral mutation was seen within 5 years among patients who had undetectable HBVDNA at the second week of treatment.The HBeAg serum conversion rate of was 62.5% in both groups during the 5 years of treatment.HBVDNA level was undetect-able after 3-4 weeks of treatment.The rate of viral breakthrough was 9.1% and the rate of HBeAg serum conversion was 45.5% in HBeAg positive group, and there was no viral breakthrough in HBeAg negative group.The virologic response and the viral breakthrough in both groups at 5-8weeks, 9-12 weeks, and 13-24 weeks were 52.4% vs 41.2%, 71.4% vs 66.7%, and 100% vs 100%, respectively during the 5 years of treatment. (P < 0.05) Conclusion A 4 week virologic response might be used to predict drug resistance and the long term effect of Lamivudine therapy in patients with chronic hepatitis B infection.It could also be used for choosing the appropriate patients to be treated with lamivudine effectively.
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