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Interferon/long‐term lamivudine combination therapy in anti‐HBe positive chronic hepatitis B patients
Author(s) -
NIKOLAIDIS NIKOLAOS L,
GIOULEME OLGA I,
TZIOMALOS KONSTANTINOS A,
SAVERIADIS ADAMOS S,
GRAMMATIKOS NIKOLAOS,
DOUKELIS PANAGIOTIS,
VOUTSAS ANASTASIOS D,
VASSILIADIS THEMISTOKLIS,
PATSIAOURA KALLIOPI,
ORFANOUKOUMERKERIDOU ELENI,
BALASKA AIKATERINI,
EUGENIDIS NIKOLAOS P
Publication year - 2005
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2005.04029.x
Subject(s) - lamivudine , medicine , discontinuation , combination therapy , hbsag , gastroenterology , interferon , hepatitis b , alpha interferon , hepatitis b virus , immunology , virus
Background: Monotherapy with a single antiviral agent is insufficient in controlling hepatitis B virus infection in the majority of patients with anti‐HBe positive chronic hepatitis B. Interferon/long‐term lamivudine combination therapy was evaluated to determine if this strategy would improve treatment efficacy and reduce the emergence of lamivudine resistance. Methods: In total, 36 consecutive anti‐HBe positive patients were treated with interferon (3 MU subcutaneously three times weekly) and lamivudine (100 mg orally once a day) for 12 months. After completion of the combined treatment, all patients continued to receive lamivudine monotherapy indefinitely. Results: Overall, 35 patients (97%) showed virological response at 12 months. Four patients (11%) cleared HBsAg and developed anti‐HBs. During the follow‐up time, after the discontinuation of interferon, of 30 ± 12 months (range: 7–57 months), 13 patients (36%) exhibited breakthrough infection. The cumulative rates of breakthrough infection at the end of 1, 2, 3 and 4 years of treatment were 0%, 14%, 32%, and 59%, respectively. Conclusions: Combination therapy appears to be effective and may also delay the selection of lamivudine‐resistant variants. However, controlled trials are definitely warranted to clarify the potential benefits of combination antiviral treatment over monotherapy.