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Sequential therapy with adefovir dipivoxil and pegylated Interferon Alfa‐2a for HBeAg‐negative patients
Author(s) -
Moucari R.,
Boyer N.,
Ripault M.P.,
Castelnau C.,
Mackiewicz V.,
Dauvergne A.,
Valla D.,
Vidaud M.,
Chanoine M.H. N.,
Marcellin P.
Publication year - 2011
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.1365-2893.2010.01332.x
Subject(s) - hbsag , adefovir , medicine , gastroenterology , serology , pegylated interferon , hbeag , combination therapy , immunology , hepatitis b virus , chronic hepatitis , ribavirin , virus , antibody , lamivudine
Summary. To assess the impact of sequential therapy with adefovir dipivoxil (ADV) and pegylated interferon alfa‐2a (PEG‐IFN) on virological (serum HBV‐DNA) and serological (serum HBsAg) response in 20 consecutive HBeAg‐negative patients. Patients received ADV for 20 weeks, then ADV and PEG‐IFN for 4 weeks and lastly PEG‐IFN for 44 weeks. Serum HBV‐DNA and HBsAg were assessed at baseline, during therapy (weeks 20, 44 and 68) and follow‐up (weeks 92 and 116). Sustained virological response (SVR) was defined as serum HBV‐DNA <10 000 copies/mL (partial) or <70 copies/mL (complete) 24 weeks after stopping treatment. A serological response was defined as a serum HBsAg decrease ≥1 log 10 IU/mL at the end of treatment. Baseline median serum HBV‐DNA and HBsAg levels were 7.6 log 10 copies/mL and 3.8 log 10 IU/mL, respectively. Ten patients (50%) achieved SVR, six of them had partial response and four complete response. Four patients (20%) achieved serological response. Complete SVRs showed a major and steep decline in HBsAg level with a median decrease of 0.5, 1.6 and 2.0 log 10 IU/mL at treatment week 20, 44 and 68, respectively. Partial SVRs showed a slight and slow decline in serum HBsAg level (0.1, 0.4, and 0.6 log IU/mL at weeks 20, 44 and 68, respectively). On‐treatment serum HBsAg decrease had a high accuracy to predict SVR (AUROC = 0.88). Our results suggest that sequential therapy might be an interesting strategy for HBeAg‐negative patients. Serum HBsAg kinetics seem to be an accurate tool to predict SVR. Large clinical trials are needed to explore this strategy with more potent analogues.