CONCISE COMMUNICATION Quantitative Hepatitis B Virus DNA Testing for the Early Prediction of the Maintenance of Response during Lamivudine Therapy in Patients with Chronic Hepatitis B

To determine whether a dramatic decrease in hepatitis B virus (HBV) DNA levels within the first months of lamivudine therapy can predict the emergence of YMDD variants in patients with chronic hepatitis B, quantitative testing was done every 3 months on serum samples from 35 patients who were treated with lamivudine for 11 year. The decline in HBV DNA levels from baseline to month 3 was higher in 22 responders than in 13 nonresponders ( , vs. log10 copies;), whereas no differences weremean SD 4.16 1.06 2.88 1.77 Pp.002 observed in patients with and without YMDD variants at 1 year of therapy. At 3 months, HBV DNA was undetectable in 77 % of the responders, whereas, after 1 year, it was unde-tectable in 23 % of nonresponders, 40 % of patients with YMDD variants, and 74 % of those without variants. Therefore, quantitative HBV DNA testing is very useful in deciding whether to continue therapy, because of the low likelihood of response in patients who remain HBV DNA positive at month 3 of treatment. Lamivudine, the first specific oral antiviral therapy for chronic hepatitis B, has been proven safe and efficacious in controlled studies, but the appropriate duration of lamivudin