FELLOWSHIP STUDY

Seroclearance of Hbsag in Chronic Hbv Patients on Lamivudine Therapy: a 10-year Experience
The University of Duhok, Kurdistan Region of Iraq

Fellowship Awarded in 2014

In 2014, I completed a Fellowship in Infectious Diseases at the University of Duhok, Iraq. My dissertation, titled "Seroclearance of HBsAg in Chronic HBV Patients on Lamivudine Therapy: A 10-Year Experience," explored the effectiveness of lamivudine therapy in achieving a rare but desirable outcome in chronic Hepatitis B infection: HBsAg seroclearance. This research was conducted under the esteemed supervision of Professor Davood Yadegarynia (MD) and Professor Sabri Sheikho (MD).

Fellowship Title

"Seroclearance of HBsAg in Chronic HBV Patients on Lamivudine Therapy: A 10-Year Experience"

Research Background and Importance

Chronic Hepatitis B infection remains a global health challenge, despite advancements in antiviral therapies. During my fellowship, I focused on lamivudine—a drug that, although no longer considered first-line treatment, has been effective in suppressing HBV-DNA and improving liver function in patients with chronic HBV.

This study is based on a 10-year clinical experience at a specialized tertiary care referral hospital in Tehran, Iran, where lamivudine (biovudin®) was used to treat chronic HBV patients. The key aim of my research was to assess the rate of HBsAg seroclearance among patients receiving lamivudine and to evaluate its effectiveness as a long-term management option.

Research Objectives

The main goals of this study were:

To determine the HBsAg seroclearance rate in chronic HBV patients undergoing lamivudine therapy over a decade.
To assess the effectiveness of lamivudine in managing chronic active HBV infection, particularly in light of newer treatment options such as tenofovir and entecavir.
To evaluate how quickly patients on lamivudine therapy experienced HBsAg seroclearance and seroconversion (the process where the body clears the virus from the bloodstream).

Key Findings

Over the course of the study, 203 chronic HBV patients were treated with lamivudine at a dose of 100 mg/day.
Of these, 11 patients achieved HBsAg seroclearance, demonstrating the effectiveness of lamivudine despite the availability of newer antiviral therapies.
On average, seroclearance occurred 26.9 months after the initiation of lamivudine therapy, with a range of 12 to 48 months.
Seroconversion was also observed in all patients, occurring within a similar timeframe to seroclearance, indicating sustained viral suppression.

While newer antiviral treatments like tenofovir and entecavir have become preferred first-line therapies due to their higher efficacy, lamivudine remains a viable, cost-effective, and safe treatment option, particularly in resource-limited settings or for patients with contraindications to newer drugs.

Impact and Future Directions

This fellowship study underscores the importance of maintaining access to affordable and effective antiviral treatments for chronic HBV infection, even as medical advancements continue to evolve. Although lamivudine is no longer the first-line choice, its role in achieving HBsAg seroclearance in select patients cannot be overlooked.

For students, colleagues, and researchers interested in infectious diseases, particularly viral hepatitis, this study offers valuable insights into the long-term management of HBV and the therapeutic potential of older antiviral agents. I look forward to collaborating on further research in this area, exploring the role of emerging therapies, and continuing efforts to improve outcomes for patients with chronic HBV.

Thank you for visiting, and please don’t hesitate to reach out if you’re interested in learning more about my research or exploring collaboration opportunities.

Qualification Details: Fellowship Study

TITLE: Seroclearance of Hbsag in Chronic Hbv Patients on Lamivudine Therapy: a 10-year Experience

AUTHOR: Muayad Aghali Merza (M.B.Ch.B., M.Sc., Ph.D.)

ISSN:

AWARDING BODY: The University of Duhok

CURRENT INSTITUTION: The University of Duhok

DATE AWARDED: 2014

Full Text Link: Please email me and will share this with you

SUPERVISOR: Dr. Sabri Sheikho (MD) and Dr. Davood Yadegarynia (MD)

SPONSOR: The University of Duhok, Kurdistan Region of Iraq

QUALIFICATION NAME: Degree of Subspecialty Fellowship in Infectious Diseases

QUALIFICATION LEVEL: Fellowship

LANGUAGE OF THE THESIS: English

REPOSITORY LINK: Forthcoming

Citation to this work:

Merza, M.A. (2014). Seroclearance of HBsAg in Chronic HBV Patients on Lamivudine Therapy: A 10-Year Experience. Fellowship Dissertation. The University of Duhok

Abstract:

Although lamivudine therapy is no longer considered as a first-line therapyfor chronic HBV infection, it remains to be effective in suppressing HBV-DNAwith ALT normalization and histologic improvement in both HBeAg-positive andHBeAg-negative patients. The aims of this study were to determine HBsAgseroclearance rate among patients treated with lamivudine at a specialized tertiarycare referral hospital in Tehran, Iran. Furthermore, to review effectiveness oflamivudine in the management of chronic active HBV infection. All patients onlamivudine (biovudin®) therapy at a dose of 100 mg/day, who showedseroclearnace between March 2001 and September 2011 were recruited. The mainevaluation parameters were duration of HBsAg seroclearance and duration ofHBsAg seroconversion. Serum alanine aminotransferase (ALT) and aspartateaminotransferase (AST) levels were evaluated using standard methods. A total of11 patients out of 203 chronic HBV patients treated with lamivudine at a dose of100 mg/day were included in the study. HBsAg seroclearance and seroconversionwere observed in all patients after the initiation of the lamivudine therapy. Overall,the mean time to HBsAg seroclearance was 26.90±10.93 months (range: 12-48months). Seroconversion occurred after a mean time of 26.90±11.08 months fromthe initiation of lamivudine therapy. Despite introduction of tenofovir andentecavir as first line treatment for chronic HBV infection, lamivudine remains tobe a low cost, safe and effective drug for HBsAg seroclearnace.

Keywords:

Lamivudine therapy, HBsAg seroclearance, Chronic HBV infection, Hepatitis B treatment, Infectious diseases

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