Τίτλος:
Interferon-alpha plus lamivudine vs lamivudine reduces breakthroughs,
but does not affect sustained response in HBeAg negative chronic
hepatitis B
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
AIM: To investigate the efficacy of combination treatment of IFN-alpha
and lamivudine compared to lamivudine monotherapy, after 24 mo of
administration in HBeAg-negative hepatitis B patients.
METHODS: Fifty consecutive patients were randomly assigned to receive
IFN-alpha-2b (5 MU thrice per week, n = 24) plus lamivudine (100 mg
daily) or lamivudine only (n = 26) for 24 mo. Patients were followed up
for further 6 mo. The primary outcome was the proportion with sustained
virological response (undetectable serum HBV DNA concentrations) and or
sustained biochemical response (transaminase levels within normal range)
at 30 mo (6 mo after the end of therapy). Secondary end-points were
timed from initial virological (biochemical) response to VBR (BBR,
respectively) and the emergence of YMDD mutants across the two arms.
RESULTS: Five of twenty-four (21%) patients in the combination arm vs
3/26 (12%) in the lamivudine arm had sustained response (i.e., normal
serum transaminase levels and undetectable HBV DNA by PCR assay) 6 mo
after treatment discontinuation. A reduction in the emergence of YMDD
mutants and in the development of virological breakthroughs was observed
in patients receiving combination treatment (10% vs 46%, P = 0.01 and
14% vs 46%, P = 0.03, respectively). Time from initial virologic
response to virologic breakthrough (VBR) was greater among initial
responders receiving combination treatment compared to those receiving
lamivudine (22.9 mo vs 15.9 mo, respectively; P = 0.005).
CONCLUSION: Our results demonstrate that IFN-a plus lamivudine
combination therapy does not increase the sustained response, compared
to lamivudine. However, combination therapy reduces the likelihood of
VBR due to YMDD mutants and prolongs the time period until the
breakthrough development. (C) 2005 The WJG Press and Elsevier Inc. All
rights reserved.
Συγγραφείς:
Economou, Michalis
Manolakopoulos, Spilios
Trikalinos, Thomas A.
and Filis, Spyros
Bethanis, Sotiris
Tzourmakliotis, Dimitrios
and Avgerinos, Alec
Raptis, Sotiris
Tsianos, Epameinondas V.
Περιοδικό:
World Journal of Gastroenterology
Εκδότης:
BAISHIDENG PUBLISHING GROUP INC
Λέξεις-κλειδιά:
Interferon; Lamivudine; Hepatitis B; Combination therapy
DOI:
10.3748/wjg.v11.i37.5882
