Combination of short-term prednisolone and adenine arabinoside in the treatment of chronic hepatitis B. A controlled study.
The efficacy of adenine arabinoside (Ara-A) alone or in combination with prednisolone utilizing its withdrawal effect was studied in 43 patients with deoxyribonucleic acid polymerase- and hepatitis B e antigen-positive chronic hepatitis. Ten patients were treated with 10 mg/kg body wt of Ara-A alone for 4-8 wk. In 9 cases, prednisolone (40 mg/day) was given at a constant dosage for 4 wk before Ara-A treatment. Fourteen patients received oral prednisolone alone for 4 wk, and 10 patients served as untreated controls. Six of 9 patients (67%) undergoing the combination therapy became seronegative for hepatitis B e antigen, whereas only 4 of 24 patients (17%) treated either with Ara-A alone or prednisolone alone lost the antigen. Two of the 10 untreated patients became seronegative for hepatitis B e antigen during the same follow-up period of 9 mo. This prospective controlled study suggests that the combination of immunomodulation by steroid withdrawal and subsequent Ara-A is more effective in the treatment of patients with chronic liver disease and active hepatitis B virus replication than treatment with Ara-A alone.
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D002908:Chronic Disease; D004259:DNA-Directed DNA Polymerase / Q000097:blood; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000378:metabolism; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D011239:Prednisolone; D000410:Alanine Transaminase; D004259:DNA-Directed DNA Polymerase; D014740:Vidarabine