Lamivudine/interferon combination therapy in anti-HBe positive chronic hepatitis B patients: A controlled pilot study

Teresa Santantonio, Grazia Anna Niro, Emanuele Sinisi, Gioacchino Leandro, Maria Insalata, Angela Guastadisegni, Domenico Facciorusso, Eleonora Gravinese, Angelo Andriulli, Giuseppe Pastore

Research output: Contribution to journalArticle

Abstract

Background/Aims: In this study, lamivudine-interferon (LAM/IFN) combination therapy was compared to LAM monotherapy to verify if the combination treatment might improve efficacy and reduce the emergence of LAM-resistant mutants. Methods: Fifty patients with anti-HBe-positive chronic hepatitis B were treated for 12 months with LAM at 100 mg/ day (26 pts) or with IFN at 5 MU t.i.w. + LAM 100 mg/day (24 pts). Serum ALT, HBV DNA and IgM anti-HBc were monitored during treatment and a 6-month follow-up. The polymerase gene was amplified by PCR and the region coding for YMDD motif was directly sequenced. Results: All patients normalized ALT and cleared HBV DNA during treatment. The response was maintained until the end of therapy in the LAM/IFN group, while in 5/26 initial responders treated with LAM alone, a virological and biochemical breakthrough was observed after 6-10 months, and selection for YMDD variants resulted. After therapy discontinuation, most patients relapsed; the response rate after 6 months was 17 % in the LAM/IFN group and 19 % in the LAM group. Conclusions: In anti-HBe-positive chronic hepatitis B, a 12-month course of LAM/IFN combination therapy is as beneficial as LAM monotherapy, however, the combination regimen appeared to prevent or delay the emergence of YMDD variants.

Original languageEnglish
Pages (from-to)799-804
Number of pages6
JournalJournal of Hepatology
Volume36
Issue number6
DOIs
Publication statusPublished - Jun 1 2002

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Keywords

  • Anti-HBe positive chronic hepatitis B
  • Antiviral therapy
  • Combination therapy
  • Drug resistance
  • Interferon
  • Lamivudine
  • YMDD mutants

ASJC Scopus subject areas

  • Gastroenterology

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