Study: AIDS Drug Effective vs. Hepatitis B

Lamivudine, a long-used AIDS drug, appears to be the first effective, long-term treatment for patients with advanced liver disease caused by hepatitis B virus (HBV), according to a study released today. While lamivudine, also known as 3TC, has been available for treatment of HBV since 1998, its long-term effects in patients with serious liver disease or cirrhosis were unknown.

Dr. Yun-Fan Liaw, of Chang Gung Memorial Hospital and University of Taipei Taiwan, and colleagues tested the drug for nearly three years in 651 patients, mostly Asians. The researchers found the drug cut in half the risk of liver failure and the chance the disease would develop into liver cancer. Of those who received lamivudine, about 8 percent saw their liver disease get worse, compared with 18 percent of those given a placebo. The study was halted because of the difference in the groups, and all patients were offered lamivudine.

"For years and years and years, we had absolutely nothing to offer patients who had advanced hepatitis-B-related liver disease. So it's a significant study," said Dr. Jack R. Wands of the Liver Research Center and Brown Medical School in Providence, R.I. Wands added that other drugs are in development that could give doctors even more potent options for treating HBV.

Liaw noted that doctors have been reluctant to use lamivudine long-term because some patients can develop resistance to the drug, which happened to about half of those in the study. Patients who develop resistance can now be switched to Hepsera, or adefovir dipivoxil, said Liaw. Hepsera was approved two years ago; the long-term effects of Hepsera are unknown. A third HBV treatment, interferon, has side effects and is typically used in patients with less advanced liver disease.

The full study, "Lamivudine for Patients with Chronic Hepatitis B and Advanced Liver Disease," was published in the New England Journal of Medicine (2004;351(15):1521-1531).

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