A randomized study of the effects of adenine arabinoside 5'-monophosphate (short or long courses) and lymphoblastoid interferon on hepatitis B virus replication.
A previous randomized controlled study has shown a 30% rate of HBe antigen/antibody seroconversion within 1 year of a month course of adenine arabinoside-5'-monophosphate; no seroconversion occurred in the control group. In this study of patients derived from the same population, 45 hepatitis B virus carriers with chronic liver disease were randomized to receive either a short (4-week) course of adenine arabinoside-5'-monophosphate, a long (7 to 8-week) course of adenine arabinoside-5'-monophosphate or a 12-week course of lymphoblastoid interferon. Long-lasting suppression of hepatitis B virus replication with disappearance of serum hepatitis B virus DNA and clearance of HBeAg occurred within 12 months of treatment in four patients who received the short course of adenine arabinoside-5'-monophosphate and in five who received interferon. Of the nine responders, four also lost HBsAg. A response to antiviral therapy was accompanied by clinical and biochemical evidence of improvement in liver disease. None of the patients who received a long course of adenine arabinoside-5'-monophosphate responded. Peripheral neuropathy and myalgia were the most serious adverse effect affecting three recipients of the short course of adenine arabinoside-5'-monophosphate and eight recipients of the long course. Thrice weekly administration of interferon was well-tolerated. Further studies to identify the characteristics of the "responder patients" and large-scale controlled trials of antiviral therapy in these subgroups are indicated.
Lok
A S
AS
Novick
D M
DM
Karayiannis
P
P
Dunk
A A
AA
Sherlock
S
S
Thomas
H C
HC
D000328:Adult; D001088:Arabinonucleotides / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D002353:Carrier State / Q000188:drug therapy* / Q000276:immunology; D004279:DNA, Viral / Q000097:blood; D004334:Drug Administration Schedule; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D005334:Fever / Q000139:chemically induced; D006509:Hepatitis B / Q000188:drug therapy* / Q000276:immunology; D006515:Hepatitis B virus / Q000187:drug effects; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D011897:Random Allocation; D013997:Time Factors; D001084:Vidarabine Phosphate / Q000009:adverse effects / Q000627:therapeutic use*; D014779:Virus Replication / Q000187:drug effects
D001088:Arabinonucleotides; D004279:DNA, Viral; D007370:Interferon Type I; D001084:Vidarabine Phosphate; D001219:Aspartate Aminotransferases