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Lamivudine vs lamivudine and interferon combination treatment of HBeAg(−) chronic hepatitis B
Author(s) -
Yurdaydin C.,
Bozkaya H.,
Çetinkaya H.,
Şahin T.,
Karaoğuz D.,
Törüner M.,
Erkan Ö.,
Heper A. O.,
Erden E.,
Bozdayi A. M.,
Uzunalimoğlu Ö.
Publication year - 2005
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2005.00566.x
Subject(s) - lamivudine , medicine , gastroenterology , hbeag , combination therapy , chronic hepatitis , hepatitis b , interferon , virology , hepatitis b virus , immunology , hbsag , virus
Summary. To determine whether combination treatment of HBeAg(−) chronic hepatitis B is beneficial we studied 78 patients with HBeAg(−), HBV DNA‐positive chronic hepatitis B who were randomized to lamivudine, 100 mg, qd, for 12 months or lamivudine–interferon (9 MU, t.i.w.) in combination. In the combination arm, 2 months of lamivudine treatment preceded 10 months of combination treatment. Biochemical, virologic and histologic responses were assessed at the end of treatment, after six and a median 27 months of drug‐free follow‐up (short‐ and long‐term follow‐up, respectively). Virologic response was defined as undetectable HBV DNA with a hybridization assay and biochemical response as normal alanine aminotransferase (ALT). Change in HBV DNA was also assessed by real‐time polymerase chain reaction (PCR). Presence of YMDD mutants at the end of treatment was investigated with a line probe assay. Both treatment regimes led to a median 2 log decline in HBV DNA levels. Virologic end of treatment responses were 90 and 92% with mono‐ and combination treatment, respectively. Corresponding virologic responses at short‐ and long‐term follow‐up were 59 and 54%, and 27 and 25%, respectively. Patients having a baseline HBV DNA value ≥200 pg/mL were more likely to relapse within 6 months off therapy than those patients with a baseline HBV DNA level <200 pg/mL ( P = 0.041). YMDD mutants were observed in 53% of patients receiving lamivudine compared with 24% of patients receiving the combination regime ( P = 0.017). In conclusion, efficay of combination treatment is similar to lamivudine monotherapy. However, combination treatment decreases the development of YMDD mutant strains compared with lamivudine monotherapy.