[A study on the clinical and pathological efficacy of lamivudine in the treatment of chronic hepatitis B].

Objective: To investigate clinical effect, liver pathohistological changes (including pathology, HBV markers in liver tissue) in patients with chronic hepatitis B.

Methods: 70 patients of chronic hepatitis B were administered 100 mg Lamivudine orally daily for 1 year. The serum HBV-DNA, HBeAg/anti-HBe, hepatic chemistry and the hepatic fibrosis markers were studied. The needle biopsy of liver were performed in 35 patients before and after treatment and Knodell pathological score were done, HBsAg, HBcAg, alpha-SMA in liver tissue were examined by immunohistochemistry method.

Results: After 1 year treatment the full response rate, partial response rate and no response rate were 23.72%, 69.49% and 6.78%, the patients in whom HBeAg seroconversion had higher base-line Alanine aminotransferase levels than the patients without seroconversion. Activity index of hepatic histology in 41.18% patients had a significant decrease. Histological assessment revealed that necrosis in portal area, pylenphlebitis and fibrosis were obviously alleviated. The liver immunohistochemistry examination showed HBcAg and alpha-SMA in liver decreased significantly in the patients with HBeAg seroconversion, no obvious alteration was observed in HBsAg expression. Lamivudine seems an effective compound with high safety and low side effect.

Conclusion: These results suggested that lamivudine (100mg/d) could suppress HBV-DNA replication, promote ALT normalization, accelerate HBeAg/anti-HBe seroconversion, improve the liver pathological changes, slow down the development of liver fibrosis