Research

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

Makoto Nakamuta¹ , Kazuhiro Kotoh¹ , Munechika Enjoji¹ , Eiji Kajiwara³ , Junya Shimono⁴ , Akihide Masumoto⁵ , Toshihiro Maruyama⁶ , Norihiro Furusyo⁷ , Hideyuki Nomura⁸ , Hironori Sakai⁹ , Kazuhiro Takahashi¹⁰ , Koichi Azuma¹¹ , Shinji Shimoda¹² , Yuichi Tanabe² and Jun Hayashi⁷

¹Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Japan

²Department of Medicine, Fukuoka City Hospital, Fukuoka, Japan

³Department of Internal Medicine, Nippon Steel Yawata Memorial Hospital, Kitakyushu, Japan

⁴Department of Medicine, Yahata Saiseikai Hospital, Kitakyushu, Japan

⁵Department of Clinical Research, National Hospital Organization Kokura Hospital, Kitakyushu, Japan

⁶Department of Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan

⁷Department of Environmental Medicine and Infectious Diseases, Graduate School of Medical Sciences, Kyushu University, Japan

⁸Department of Internal Medicine, Shin-Kokura Hospital, Kitakyushu, Japan

⁹Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

¹⁰Department of Medicine, Hamanomachi Hospital, Fukuoka, Japan

¹¹Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan

¹²Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Japan

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Comparative Hepatology 2007, 6:3doi:10.1186/1476-5926-6-3

Published:	1 May 2007

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 (Δ-albumin) and various pretreatment variables. We also analyzed the correlation between Δ-albumin and the reduction in serum levels of HBV-DNA (Δ-HBV-DNA) or alanine aminotransferase (Δ-ALT) at month 12.

Results

The average Δ-albumin was 0.38 g/dL and only serum HBV-DNA levels before treatment correlated significantly with Δ-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 Δ-albumin and either pretreatment alanine aminotransferase levels or Δ-ALT. In contrast, in patients whose serum HBV-DNA was undetectable at month 12, we found a significant correlation between Δ-albumin and both pretreatment serum HBV-DNA levels and Δ-HBV-DNA.

Conclusion

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