Lamivudine Therapy for Chronic Hepatitis B

Review Article

Lamivudine Therapy for Chronic Hepatitis B

Wai‐Kay Seto, Ching‐Lung Lai, James Fung and Man‐Fung Yuen

Affiliation:  Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong


ABSTRACT

Lamivudine was introduced as an antiviral for chronic hepatitis B over a decade ago. Its role in the management of CHB has been constantly changing. Lamivudine has proven benefit in both hepatitis B e antigen‐positive and ‐negative patients. It is able to alter the clinical outcomes of chronic hepatitis B patients and reduce the rates of cirrhotic complications and hepatocellular carcinoma. However, it has a low genetic barrier towards resistance; lamivudine resistance is a continuing and challenging problem in the management of chronic hepatitis B. Lamivudine also has a role in combination therapy, pre‐emptive therapy for patients receiving chemotherapy, and treatment in other special population groups. Although currently not a first‐line treatment for chronic hepatitis B, there are certain patient subgroups that may benefit from lamivudine therapy. With the extensive experience of widespread use of lamivudine, the long‐term safety of lamivudine has been well established.

Keywords: hepatitis B, lamivudine, hepatitis B virus (HBV) DNA, hepatitis B e antigen (HBeAg), YMDD, resistance, antiviral

Correspondence: Man‐Fung Yuen, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong. Tel: (852)‐22553984; Fax: (852)‐28162863; e‐mail: mfyuen@hkucc.hku.hk