Olone modulates the therapeutic effect of interferon to eliminate preferentially the hepatitis B virus precore stop mutant.
OBJECTIVE
The aim of this study was to understand the changes in the proportion of hepatitis B virus precore stop mutant during the course of prednisolone primed interferon (IFN) therapy.


METHODS
Three groups of patients were included: patients receiving prednisolone-primed IFN treatment (Group I, n=31), IFN treatment only (Group II, n=29), and placebo (Group III, n=25). The proportion of precore stop mutant was measured by a quantitative amplification-created restriction site method.


RESULTS
Distinct patterns of the progression of the proportion of mutant were found among these three groups. A steady increase in the proportion of mutant was observed only in Group III patients. In Group II patients, the presence of a higher percentage of mutant (> 25%) immediately before IFN treatment was predictive for the subsequent clearance of hepatitis B e antigen (HBeAg) (p<0.01), but not for complete anti-viral response (p>0.05). Prednisolone pretreatment resulted in an increase in the proportion of mutant in patients with initially low percentages (< or = 25%) of mutant. During the period of IFN treatment, both the relative and absolute amount of the precore stop mutant decreased significantly in Group I patients who cleared HBeAg. The presence of such a decrease in this group of patients was predictive for both HBeAg clearance and complete anti-viral response.


CONCLUSIONS
Our data suggest that prednisolone serves as a modulator to enhance elimination of precore stop mutant by IFN, which advocates the benefit of corticosteroid pretreatment in an area where the precore mutants are prevalent.
Yeh
C T
CT
Liver Research Unit, Chang Gung Memorial Hospital and Chang Gung University School of Medicine, Taipei, Taiwan.
Sheen
I S
IS
Chen
T C
TC
Hsieh
S Y
SY
Chu
C M
CM
Liaw
Y F
YF
D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D004347:Drug Interactions; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000008:administration & dosage* / Q000627:therapeutic use*; D009154:Mutation; D011239:Prednisolone / Q000494:pharmacology* / Q000627:therapeutic use*; D016896:Treatment Outcome; D014758:Viral Core Proteins / Q000235:genetics
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D014758:Viral Core Proteins; D007372:Interferons; D011239:Prednisolone