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Effects of lamivudine on serum albumin levels correlate with pretreatment HBV-DNA levels in cirrhotic patients.

Nakamuta M, Kotoh K, Enjoji M, Kajiwara E, Shimono J, Masumoto A, Maruyama T, Furusyo N, Nomura H, Sakai H, Takahashi K, Azuma K, Shimoda S, Tanabe Y, Hayashi J - Comp Hepatol (2007)

Bottom Line: We hypothesized that the improvement of hypoalbuminemia by lamivudine may be attributable to the reduction of HBV replication itself, rather than to cessation of hepatitis.Fifty-four patients (Child-Pugh A/B/C, 35/9/10) with HBV-related liver cirrhosis who had been treated with lamivudine for more than 12 months were evaluated.In contrast, in patients whose serum HBV-DNA was undetectable at month 12, we found a significant correlation between Delta-albumin and both pretreatment serum HBV-DNA levels and Delta-HBV-DNA.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Japan. nakamuta@qmed.hosp.go.jp

ABSTRACT

Background: Lamivudine treatment has been recently demonstrated to increase the serum albumin levels in cirrhotic patients with hepatitis B virus (HBV) infection, but the precise mechanism remains unclear. We hypothesized that the improvement of hypoalbuminemia by lamivudine may be attributable to the reduction of HBV replication itself, rather than to cessation of hepatitis. In order to confirm this hypothesis, in this study we evaluated factors which correlated with the increase in serum albumin levels. Fifty-four patients (Child-Pugh A/B/C, 35/9/10) with HBV-related liver cirrhosis who had been treated with lamivudine for more than 12 months were evaluated. We analyzed the correlation between the increase in serum albumin levels at month 12 after starting treatment (Delta-albumin) and various pretreatment variables. We also analyzed the correlation between Delta-albumin and the reduction in serum levels of HBV-DNA (Delta-HBV-DNA) or alanine aminotransferase (Delta-ALT) at month 12.

Results: The average Delta-albumin was 0.38 g/dL and only serum HBV-DNA levels before treatment correlated significantly with Delta-albumin. We also analyzed the correlation in patients whose alanine aminotransferase levels were normalized after 12 months so that the possible influence of breakthrough hepatitis could be excluded. Even among this subgroup of patients, there was no significant correlation between Delta-albumin and either pretreatment alanine aminotransferase levels or Delta-ALT. In contrast, in patients whose serum HBV-DNA was undetectable at month 12, we found a significant correlation between Delta-albumin and both pretreatment serum HBV-DNA levels and Delta-HBV-DNA.

Conclusion: Our results demonstrated that albumin levels are associated with pretreatment HBV-DNA but not with alanine aminotransferase levels.

No MeSH data available.


Related in: MedlinePlus

Correlation between ALT levels before treatment and Δ-albumin (A), and Δ-ALT and Δ-albumin (B). In patients whose serum ALT levels were normalized at 12 months after treatment, there was no significant correlation Δ-albumin and pretreatment serum ALT levels (A). There was also no significant correlation Δ-albumin and Δ-ALT (B).
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Figure 2: Correlation between ALT levels before treatment and Δ-albumin (A), and Δ-ALT and Δ-albumin (B). In patients whose serum ALT levels were normalized at 12 months after treatment, there was no significant correlation Δ-albumin and pretreatment serum ALT levels (A). There was also no significant correlation Δ-albumin and Δ-ALT (B).

Mentions: Although we found no correlation between Δ-albumin and pretreatment serum ALT levels for the entire patient population, the possibility remained that breakthrough hepatitis or continuous elevation of ALT might interfere with Δ-albumin. Indeed, two patients showed breakthrough hepatitis, where ALT levels increased to over 100 U/L, and 20 patients still showed abnormally high ALT (> 35 U/L) at 12 months after treatment. We next evaluated the correlation between Δ-albumin and pretreatment serum ALT levels among the 32 patients in whom serum ALT levels were normalized (< 35 U/L) at 12 months after the start of therapy. As shown in Figure 2A, there was no significant correlation between Δ-albumin and pretreatment serum ALT levels in this subgroup of patients (r = 0.083, p = 0.64). We also evaluated the correlation between Δ-albumin and reduction in ALT levels at month 12 after starting treatment (Δ-ALT) in this group, but there was still no significant correlation between Δ-albumin and Δ-ALT (r = 0.0685, p = 0.67) (Figure 2B).


Effects of lamivudine on serum albumin levels correlate with pretreatment HBV-DNA levels in cirrhotic patients.

Nakamuta M, Kotoh K, Enjoji M, Kajiwara E, Shimono J, Masumoto A, Maruyama T, Furusyo N, Nomura H, Sakai H, Takahashi K, Azuma K, Shimoda S, Tanabe Y, Hayashi J - Comp Hepatol (2007)

Correlation between ALT levels before treatment and Δ-albumin (A), and Δ-ALT and Δ-albumin (B). In patients whose serum ALT levels were normalized at 12 months after treatment, there was no significant correlation Δ-albumin and pretreatment serum ALT levels (A). There was also no significant correlation Δ-albumin and Δ-ALT (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1884174&req=5

Figure 2: Correlation between ALT levels before treatment and Δ-albumin (A), and Δ-ALT and Δ-albumin (B). In patients whose serum ALT levels were normalized at 12 months after treatment, there was no significant correlation Δ-albumin and pretreatment serum ALT levels (A). There was also no significant correlation Δ-albumin and Δ-ALT (B).
Mentions: Although we found no correlation between Δ-albumin and pretreatment serum ALT levels for the entire patient population, the possibility remained that breakthrough hepatitis or continuous elevation of ALT might interfere with Δ-albumin. Indeed, two patients showed breakthrough hepatitis, where ALT levels increased to over 100 U/L, and 20 patients still showed abnormally high ALT (> 35 U/L) at 12 months after treatment. We next evaluated the correlation between Δ-albumin and pretreatment serum ALT levels among the 32 patients in whom serum ALT levels were normalized (< 35 U/L) at 12 months after the start of therapy. As shown in Figure 2A, there was no significant correlation between Δ-albumin and pretreatment serum ALT levels in this subgroup of patients (r = 0.083, p = 0.64). We also evaluated the correlation between Δ-albumin and reduction in ALT levels at month 12 after starting treatment (Δ-ALT) in this group, but there was still no significant correlation between Δ-albumin and Δ-ALT (r = 0.0685, p = 0.67) (Figure 2B).

Bottom Line: We hypothesized that the improvement of hypoalbuminemia by lamivudine may be attributable to the reduction of HBV replication itself, rather than to cessation of hepatitis.Fifty-four patients (Child-Pugh A/B/C, 35/9/10) with HBV-related liver cirrhosis who had been treated with lamivudine for more than 12 months were evaluated.In contrast, in patients whose serum HBV-DNA was undetectable at month 12, we found a significant correlation between Delta-albumin and both pretreatment serum HBV-DNA levels and Delta-HBV-DNA.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Japan. nakamuta@qmed.hosp.go.jp

ABSTRACT

Background: Lamivudine treatment has been recently demonstrated to increase the serum albumin levels in cirrhotic patients with hepatitis B virus (HBV) infection, but the precise mechanism remains unclear. We hypothesized that the improvement of hypoalbuminemia by lamivudine may be attributable to the reduction of HBV replication itself, rather than to cessation of hepatitis. In order to confirm this hypothesis, in this study we evaluated factors which correlated with the increase in serum albumin levels. Fifty-four patients (Child-Pugh A/B/C, 35/9/10) with HBV-related liver cirrhosis who had been treated with lamivudine for more than 12 months were evaluated. We analyzed the correlation between the increase in serum albumin levels at month 12 after starting treatment (Delta-albumin) and various pretreatment variables. We also analyzed the correlation between Delta-albumin and the reduction in serum levels of HBV-DNA (Delta-HBV-DNA) or alanine aminotransferase (Delta-ALT) at month 12.

Results: The average Delta-albumin was 0.38 g/dL and only serum HBV-DNA levels before treatment correlated significantly with Delta-albumin. We also analyzed the correlation in patients whose alanine aminotransferase levels were normalized after 12 months so that the possible influence of breakthrough hepatitis could be excluded. Even among this subgroup of patients, there was no significant correlation between Delta-albumin and either pretreatment alanine aminotransferase levels or Delta-ALT. In contrast, in patients whose serum HBV-DNA was undetectable at month 12, we found a significant correlation between Delta-albumin and both pretreatment serum HBV-DNA levels and Delta-HBV-DNA.

Conclusion: Our results demonstrated that albumin levels are associated with pretreatment HBV-DNA but not with alanine aminotransferase levels.

No MeSH data available.


Related in: MedlinePlus