News from Hepatitis Week of April 27, 2003 / Vol. 3 No. 17

Study: Way Found to Predict If Hepatitis B Patients Will Respond to Lamivudine

American and Italian researchers have found a way to predict which hepatitis-B infected patients will reject or resist the drug lamivudine and which ones will respond successfully.

The researchers from Georgetown University Medical Center and Ospedale S. Giovanni Battista in Torino, Italy, presented their findings April 28 at the International Conference for Antiviral Research in Savannah, Ga.

Lamivudine is one of the most commonly used treatments for chronic hepatitis B, which can lead to progressive liver disease, liver failure or primary liver cancer if left untreated.

Although Lamivudine has been proven effective in fighting hepatitis B, two-thirds of those treated with the drug develop a resistance to it. As a result, many physicians do not prescribe Lamivudine until their patients become clinically ill.

"Doctors currently play wait and see -- wait until you get sick and then we'll see if lamivudine works," said researcher Dr. John Gerin, professor of microbiology and immunology at Georgetown University Medical Center. "With a precise, predictive system in place, we can give patients immediate and targeted treatment rather than forcing them to wait until they become very ill."

Gerin and his colleagues followed 26 hepatitis-B positive people through 21-48 months of lamivudine treatment. Seven of the patients responded to the drug, while twelve patients initially responded and then developed a resistance and seven did not respond to at all.

Piror to treatment, the researchers detected two separate DNA markers in the virus genome in all of those who eventually were resistant to lamivudine or did not respond at all. None of the responders had these markers.

"We looked at a region of the virus that hasn't been routinely studied in depth before," said Korba. "Frankly, we were stunned to see that we could in fact clearly distinguish markers between the three groups and link them directly to that patients' degree of success with lamivudine."

"In an era of skyrocketing medical costs, the cost savings in not treating patients who will not respond may be a profound public health advantage," said Gerin. "We will continue to work with our colleagues to expand upon and further confirm these findings."

Other sources: International Society for Antiviral Research