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Combination of pegylated interferon and lamivudine for patients with chronic hepatitis B who have failed treatment |
Shiv K. Sarin, Manoj Kumar, Syed Hissar and Barjesh C. Sharma |
New Delhi, India
Author Affiliations: Department of Gastroenterology, G.B. Pant Hospital, New Delhi-110002, India (Sarin SK, Kumar M, Hissar S and Sharma BC)
Corresponding Author: Shiv K. Sarin, MD, DM, FNA, FNASc, Director Professor and Head, Room No. 201, Academic Block, Department of Gastroenterology, G.B. Pant Hospital, New Delhi-110002, India (Fax: 91-11-23239710; Email: sksarin@nda.vanl.net.in) |
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Abstract BACKGROUND: Treatment of chronic hepatitis B (CHB) alone with interferon or lamivudine alone or in combination is effective in only a small proportion of patients. Treatment of patients in whom antiviral therapy fails is challenging. This study was made to determine the efficacy of combined pegylated interferon alpha (peg-IFN) and lamivudine in patients with CHB who had failed to respond to antiviral treatment.
METHODS: Twenty patients with CHB proven by liver biopsy, with ALT levels >1.5×ULN, HBV DNA levels>141 500 copies/ml, and previous treatment failure with an adequate regimen were treated with a combination of peg-IFN 1.5 µg/kg and lamivudine 100 mg/day for 52 weeks and followed up for a further 24 weeks. Biochemical response was defined as normalization of ALT and DNA response as HBV DNA<141 500 copies/ml. Secondary efficacy measures included HBsAg loss, HBeAg loss and appearance of anti-HBe (in cases of HBeAg-positive patients).
RESULTS: Twenty patients were treated, of whom 16 were HBeAg positive. At 52 weeks, normal ALT was seen in 10 (50%) (8 of 16 HBeAg+ and 2 of 4 HBeAg-), HBV DNA response in 5 (25%) (5 of 16 in HBeAg+ and none in HBeAg-), and HBeAg loss with appearance of anti-HBe in 5 (31.3%) of the 16 HBeAg positive patients. At 76 weeks, 8 (80%) of the 10 patients with normal ALT at 52 weeks relapsed, with normal ALT only in 2 (10%) (1 of 16 HBeAg+ and 1 of 4 HBeAg-), and all 5 patients who had a DNA response at 52 weeks relapsed at 76 weeks and had no DNA response. HBeAg loss with appearance of anti-HBe was seen in 1 (6.3%) of 16 HBeAg-positive patients. None of the patients lost HBsAg.
CONCLUSIONS: The combination of peg-IFN and lamivudine for 52 weeks is not effective for treatment of CHB patients with a failed treatment. New treatment strategies need to be developed.
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Cite this article: |
Sarin SK,
Kumar M,
Hissar S,
et al.
Combination of pegylated interferon and lamivudine for patients with chronic hepatitis B who have failed treatment.
Hepatobiliary Pancreat Dis Int
2006;
5(3):
374-380. DOI:
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URL: |
http://dx.doi.org/ OR http://www.hbpdint.com/EN/Y2006/V5/I3/374 |
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