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AIM:To study the sequential changes of serum ferritin levelsin lamivudine-treated patients with chronic viral hepatitis Band the clinical implications.METHODS:Thirty-eight patients with chronic viral hepatitisB were prospectively studied during their treatment withlamivudine.Each patient received 100 mg oral lamivudinedaily for 12 mo,and was observed and tested for bloodbiochemistry and hepatitis B virus (HBV) DNA levels andserum ferritin levels at baseline and at 3,6 and 12 moduring the treatment.Serum HBV DNA levels werequantitatively determined using fluorescent quantitativepolymerase chain reaction (FQ-PCR),and serum ferritinlevels were measured by radioimmunoassay.The sequentialchanges of serum ferritin levels and their relationships withvirological,serological and biochemical responses in thepatients were analyzed.RESULTS:All the patients had a baseline HBV DNA levelhigher than 1×10~7 copies/L as determined by FQ-PCR andpositive HBsAg and HBeAg and abnormal ALT levels.At theend of the 12-mo treatment,19 of the 38(50.00%) patientshad undetectable serum HBV DNA levels by FQ-PCR,and12(31.58%) became negative for serum HBeAg and 10(26.32%)had seroconversion from HBeAg to HBeAb.Nineteen out ofthe 38(50.00%) patients had biochemically normal ALT levelsafter 12-mo lamivudine treatment.Sequential determinationshowed that lamivudine treatment significantly reduced ferritinlevels in chronic hepatitis B patients.When the patients weredivided into different groups according to their post-treatment virological,serological and biochemical responsesfor analysis of the sequential changes of ferritin levels,it wasfound that the decrease of ferritin levels in HBV DNA-negativegroup was significantly more obvious than that in HBV DNA-positive group at 6 mo during the treatment (P=0.013).Consecutive comparisons showed that ferritin levels at 3 moof treatment were obviously decreased as compared withthe baseline levels (P<0.05) in HBeAg-negative group,andthe decrease of serum ferritin levels in patients with normalizedALT was more significant than that in patients with abnormalALT at the end of the 12-mo treatment (P=0.048).CONCLUSION:Lamivudine treatment can reduce the serum ferritin levels in chronic viral hepatitis B patients anddecreases of ferritin levels can be more significant in patientsexhibiting virological,serological and biochemical responses,indicating that dynamic observation of serum ferritin levelsin patients with chronic viral hepatitis B during lamivudinetreatment might be helpful for monitoring and predictingpatients’ responses to the therapy.
AIM: To study the sequential changes of serum ferritin levels in lamivudine-treated patients with chronic viral hepatitis Band the clinical implications. METHHODS: Thirty-eight patients with chronic viral hepatitis B were prospectively studied during their treatment withlamivudine. Each patient received 100 mg oral lamivudinedaily for 12 mo, and was observed and tested for blood biochemistry and hepatitis B virus (HBV) DNA levels and ferritin levels at baseline and at 3, 6 and 12 moduring the treatment.Serum HBV DNA levels were quantitatively determined using fluorescent quantitative polymerase chain reaction (FQ-PCR ), and serum ferritinlevels were measured by radioimmunoassay. The sequentialchanges of serum ferritin levels and their relationships withvirological, serological and biochemical responses in thepatients were analyzed.RESULTS: All the patients had a baseline HBV DNA levelhigher than 1 × 10 ~ 7 copies / L as determined by FQ-PCR and positive HBsAg and HBeAg and abnormal ALT levels. At the end of the 12-mo treatment, 19 of the 38 (50.00%) patientshad undetectable serum HBV DNA levels by FQ-PCR, and12 (31.58%) became negative for serum HBeAg and 10 (26.32%) had seroconversion from HBeAg to HBeAb.Nineteen Out of the 38 (50.00%) patients had biochemically normal ALT levels after 12-mo lamivudine treatment. Sequential determinations showed that lamivudine treatment significantly reduced ferritin levels in chronic hepatitis B patients. Who the patients weredivided into different groups according to their post-treatment virological, serological and biochemical responsesfor analysis of the sequential changes of ferritin levels, it wasfound that the decrease of ferritin levels in HBV DNA-negativegroup was significantly more than than in HBV DNA-positive group at 6 mo during the treatment (P = 0.013) .Consecutive comparisons showed that ferritin levels at 3 moof treatment were obviously decreased as compared with the baseline levels (P <0.05) in HBeAg-negative group, and the decrease of serum ferritin levels in patients with normalizedALT was more significant than that in patients with abnormalALT at the end of the 12-mo treatment (P = 0.048) .CONCLUSION: Lamivudine treatment can reduce the serum ferritin levels in chronic viral hepatitis B patients and cancers of ferritin levels can be more significant in patient seχhibiting virological, serological and biochemical responses, indicating that dynamic observation of serum ferritin levels in patients with chronic viral hepatitis B during lamivudinetreatment ’m able to be monitoring and predictingpatients’ responses to the therapy.