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Researchers discover method of predicting drug resistance in hepatitis-B patients

Researchers at Georgetown University Medical Center have discovered a way to predict which hepatitis-B infected patients will respond successfully to the drug lamivudine--one of the most commonly used treatments for this illness--and which are likely to develop drug resistance or reject the drug altogether. This research was presented today at the 16th International Conference for Antiviral Research in Savannah, Georgia.

Left untreated, chronic hepatitis-B infection can lead to progressive liver disease, liver failure, or primary liver cancer. It affects more than 400 million people worldwide. Despite lamivudine's efficacy in treating hepatitis B (HBV), many doctors do not prescribe the drug until patients become clinically ill for fear that the patient will develop a drug resistance that will render lamivudine and other HBV treatments ineffective. Drug resistance occurs in approximately two thirds of treated patients.

"We have long struggled with one tough question: how do you treat those HBV-positive people who have the best chance at responding to lamivudine treatment and determine those who will fail treatment?," said Dr. John Gerin, professor of microbiology and immunology at Georgetown University Medical Center. "Doctors currently play 'wait and see' wait until you get sick and then we'll see if lamivudine works. With a precise, predictive system in place, we can give patients immediate and targeted treatment rather than forcing them to wait until they become very ill."

Gerin, along with Dr. Brent Korba, professor of microbiology at Georgetown, and colleagues from Ospedale S. Giovanni Battista in Torino, Italy, followed 26 hepatitis-B positive people through 21-48 months of lamivudine treatment. Seven of those patients, classified as "responders," had permanent remission of the disease. Twelve patients, who were considered "breakthroughs," experienced initial success but then ultimately slid back into active infection due
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Contact: Elizabeth McDonald
eem6@georgetown.edu
202-687-5100
Georgetown University Medical Center
28-Apr-2003


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