Basic Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2005; 11(44): 6948-6953
Published online Nov 28, 2005. doi: 10.3748/wjg.v11.i44.6948
Relationship between body surface area and ALT normalization after long-term lamivudine treatment
Makoto Nakamuta, Shusuke Morizono, Yuichi Tanabe, Eiji Kajiwara, Junya Shimono, Akihide Masumoto, Toshihiro Maruyama, Norihiro Furusyo, Hideyuki Nomura, Hironori Sakai, Kazuhiro Takahashi, Koichi Azuma, Shinji Shimoda, Kazuhiro Kotoh, Munechika Enjoji, Jun Hayashi: Kyushu University liver Disease Study Group
Makoto Nakamuta, Shusuke Morizono, Munechika Enjoji, Kazuhiro, Kotoh, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Japan
Norihiro Furusyo, Jun Hayashi, Department of Environmental Medicine and Infectious Diseases, Graduate School of Medical Sciences, Kyushu University, Japan
Shinji Shimoda, Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Japan
Koichi Azuma, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
Yuichi Tanabe, Department of Medicine, Fukuoka City Hospital, Fukuoka, Japan
Eiji Kajiwara, Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu, Japan
Junya Shimono, Department of Medicine, Yahata Saiseikai Hospital, Kitakyushu, Japan
Akihide Masumoto, Department of Clinical Research, National Hospital Organization Kokura Hospital, Kitakyushu, Japan
Toshihiro Maruyama, Department of Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
Hideyuki Nomura, Department of Internal Medicine, Shin-Kokura Hospital, Kitakyushu, Japan
Hironori Sakai, Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
Kazuhiro Takahashi, Department of Medicine, Hamanomachi Hospital, Fukuoka, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Makoto Nakamuta, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-5282, Japan. nakamuta@intmed3.med.kyushu-u.ac.jp
Telephone: +81-92-6425282 Fax: +81-92-6425287
Received: April 20, 2005
Revised: May 8, 2005
Accepted: May 12, 2005
Published online: November 28, 2005
Abstract

AIM: To further evaluate the relationship between BSA and the effects of lamivudine in a greater number of cases and over a longer period of observation than in our previous evaluation.

METHODS: We evaluated 249 patients with chronic hepatitis B. The effects of treatment for one year (n = 249), two years (n = 147), and three years (n = 72) were evaluated from the levels of serum ALT and HBV-DNA, as biological and virological effects (undetectable levels by PCR), respectively. Moreover, several variables that could influence the response to treatment, including ALT, albumin, bilirubin, platelet counts, BSA, HBV-DNA, and HBeAg were analyzed.

RESULTS: For 1-year treatment, multivariate analysis revealed that BSA (P = 0.0002) was the only factor for the biological effect, and that ALT (P = 0.0017), HBV-DNA (P = 0.0004), and HBeAg (P = 0.0021) were independent factors for the virological effect. For 2-year treatment, multivariate analysis again showed that BSA (P = 0.0147) was the only factor for the biological effect, and that ALT (P = 0.0192) and HBeAg (P = 0.0428) were independent factors for the virological effect. For 3-year treatment, multivariate analysis, however, could not reveal BSA (P = 0.0730) as a factor for the normalization of ALT levels.

CONCLUSION: BSA is a significant predictor for the normalizing the effect of lamivudine therapy on ALT for an initial 2-year period, suggesting that lamivudine dosage should be based on the individual BSA.

Keywords: Lamivudine; Hepatitis B virus; Body surface area; Dose; Long-term treatment