[A clinical study on lamivudine treatment for advanced schistosomisis with chronic B hepatits]

Objective: to explore the clinical effect of LVD on patients with advanced schistosomiasis with chronic B hepatitis and on the course of disease development.

Methods: A total of 58 patients with advanced schistosomiasis with chronic B hepatitis were enrolled and randomly divided into the treatment group (30 cases) and the control group (28 cases).patients in the treatment group received routinet colligative treatment and LVD 100 mg daily, while patients in the control group received routinet colligative treatment only.All the patients were followed up for 36 +/- 3 months.

Results: The mortality rate was 13.33% vs. 55.56% in the treatment and control (P < 0.01). The patients whose Child-Pugh score decreased by more than 2 were 89.2% vs. 62.3% (P < 0.05). After treatment the serum ALT TBIL levels dropped, the serum albumin level increased and The improvement of liver function in the treatment group was better than that in the control group(P < 0.01). The HBeAg and HBV-DNA negutive rate in the treatment group were higher than those in the control (P < 0.01). The HBV-DNA negative rate in thetreatment group was 93.3% at the end of 12 weekes. The rate of YMDD mutations was 6.7%, 23.3% and 40% in the treatment group at the end of 48 , 96 and 144 weeks. LVD and ADV can inhibit virus replication and the relative stability liver function remained the same in most YMDD mutation patients.

Conclusion: LVD can inhibit virus replication rapidly and improveliver function, prevent exacerbation in patients with advanced schistosomiasis with chronic B hepatitis, LVD and ADV can inhibit virus replication and improve liver function in most YMDD mutation patients.