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Lamivudine/pegylated interferon alfa‐2b sequential combination therapy compared with lamivudine monotherapy in HBeAg‐negative chronic hepatitis B
Author(s) -
Vassiliadis Themistoklis,
Tziomalos Konstantinos,
Patsiaoura Kalliopi,
Zagris Thomas,
Giouleme Olga,
Soufleris Konstantinos,
Grammatikos Nikolaos,
Theodoropoulos Konstantinos,
Mpoumponaris Alexandros,
Dona Konstantina,
Zezos Petros,
Nikolaidis Nikolaos,
OrfanouKoumerkeridou Eleni,
Balaska Aikaterini,
Eugenidis Nikolaos
Publication year - 2007
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.1440-1746.2007.05103.x
Subject(s) - lamivudine , medicine , combination therapy , pegylated interferon , gastroenterology , hbeag , interferon alfa , alpha interferon , hepatitis b , hepatitis b virus , pharmacology , chronic hepatitis , interferon , virology , hbsag , virus , ribavirin
Background and Aim: Monotherapy has been proven insufficient in achieving sustained control of chronic hepatitis B. We aimed to assess the efficacy of combined sequential administration of lamivudine and pegylated interferon alfa‐2b in patients with hepatitis Be antigen (HBeAg)‐negative chronic hepatitis B. Methods: Eighteen patients were given sequential combination treatment starting with 3 months of lamivudine monotherapy followed by 9 months of pegylated interferon alfa‐2b (after a 3‐month period of concomitant administration of the two drugs) and 24 patients received lamivudine monotherapy. Results: At the end of treatment, 88.9% of the patients who received sequential combination treatment and 70.8% of those who received lamivudine monotherapy had hepatitis B virus (HBV) DNA levels below 400 copies/mL ( P = not significant). At the end of treatment, 72.2% of the patients who received sequential combination treatment and 70.8% of those who received lamivudine monotherapy achieved alanine aminotransferase normalization ( P = not significant). After 12 months of follow up, 33.3% of the patients who received sequential combination treatment and 16.7% of those who received lamivudine monotherapy had HBV‐DNA levels below 400 copies/mL ( P = 0.4). After 12 months of follow up, 72.2% of the patients who received sequential combination treatment and 25.0% of those who received lamivudine monotherapy had normal alanine aminotransferase levels ( P < 0.01). Twenty‐five percent of the patients in the lamivudine monotherapy group had virological breakthrough compared to none in the sequential combination treatment group ( P = 0.06). Conclusions: Sequential combination treatment is able to improve sustained biochemical response rates and prevent the emergence of lamivudine‐resistant mutants in patients with HBeAg‐negative chronic hepatitis B.