اثر لامي وودين بر عملكرد كبدي و وضعيت باليني مبتلايان به سيروز

Effects of Lamivudine on Function of Liver and Clinical Condition in Patients with Decompensated Cirrhosis

Introduction: Decompensated cirrhosis resulting from chronic hepatitis B causes a significant decrease in survival of these patients. Prescription of Alpha interferon for these patients is forbidden. Several studies have shown the effectiveness of Lamivudine in decreasing the Symptoms arising from this decompensation. Objective: The aim of this study is to determine the effect of Larnivudine on liver function and clinical status of the patients with decompensated cirrhosis arising from HBV presenting to the Supporting Center of patients with liver diseases or those being hospitalized at Gastrology Department of Imam Khomeini Hospital. Materials and methods: In a clinical trial on the basis of liver consideration in 55 patients with cirrhosis that had positive HbsAg, positive HBV DNA, child-pugh score more than 8, but not with positive HCV Ab or positive HIV Ab and creatinin of serum, more than 2 mg/dl, they were treated with 100 mg of Lamivudine tablets daily.In these patients, serum level of bilirubin, albumin, ALT, AST and also the .PT coagulation time (on the basis of INR) were controlled at the beginning of study and then at intervals of 2 to 6 months and finally 12 months after the start of treatment and in terms of presence and intensity of ascites and encephalopathy, the patients were examined by a physician. Also at the beginning of the study and 6 and I2 months later, HB s, Ag, HBV DNA, Hbe Ag and Hbe Ab were checked. On the basis of the table related to child-pugh, its amount was calculated at the beginning of the study and at intervals of 2 to 6 months and then 12 months. Results: 5 patients died in the first 6 months of treatments. The following results are related to 50 patients being under treatment with Lamivudine at least for a period of 6 months. In these patients mean child-(p<.0001) and mean ALT patients (22%) had Hbe Ag seroconversion after 6 months of treatments and 5 (26%) after a 12-month treatment with Lamivudine. All of the patients tolerated this drug very well. Conclusion: Lamivudine can be effective in improvement of liver function in patients with decompensated liver cirrhosis resulting from HBV, but for determination of proper period of treatment, further studies are necessary.