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

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.Our results demonstrated that albumin levels are associated with pretreatment HBV-DNA but not with alanine aminotransferase levels.Chronic hepatitis B is an important cause of morbidity and mortality resulting from cirrhosis-related liver failure and hepatocelluar carcinoma (HCC) [1-3]. Lamivudine, a nucleoside analogue with potent antiviral effects against hepatitis B virus (HBV), has been shown to be effective both in patients with chronic hepatitis and also those with liver cirrhosis [4-6]. In cirrhotic patients, decreased HBV-DNA loads following lamivudine treatment result in decreased serum levels of alanine aminotransferase (ALT), increased serum albumin levels, and improvement of the Child-Pugh score [7-13]. The underlying mechanism for the increase in albumin levels after lamivudine treatment has not been determined. It has been suggested that the improvement of hypoalbuminemia may be attributable to the cessation of hepatic inflammation. However, earlier treatments such as glycyrrhizin, ursodeoxycholic acid [14,15], predonisolone [16], and Stronger Neo-Minophagen C therapy [17], all of which reduce ALT levels in viral cirrhotic patients, do not result in improvement of hypoalbuminemia. Furthermore, it has been shown that there is no significant correlation between serum ALT levels and HBV-DNA loads in patients