title: Lamivudine and IFN-beta sequential therapy in HBe antigen-positive patients with chronic hepatitis B virus genotype C infection.
abstract: Sequential treatment with lamivudine and interferon (IFN) has induced sustained biochemical and virologic responses in the majority of patients with chronic hepatitis B in France. However, the efficacy of sequential treatment in patients with chronic hepatitis B virus (HBV) genotype C infection has not been evaluated. Twenty-four HBe antigen-positive patients were treated with 100 mg lamivudine alone for 16-32 weeks, then with both 6 MU IFN-beta and lamivudine for 4 weeks, and lastly with IFN-beta alone for 20 weeks. Sustained response was achieved in 7 (29%) patients 24 weeks after the end of therapy. No lamivudine-resistant variants emerged in any patient. Hepatitis flare occurred in 3 patients after the withdrawal of lamivudine, but none had decompensation. The patients with sustained response were significantly younger at baseline (p = 0.033) and had a significantly lower HBV DNA level at the start of IFN (p = 0.020) than those without sustained response. In conclusion, the rate of response to sequential therapy with lamivudine and IFN in HBe antigen-positive patients with HBV genotype C infection was lower than the rate reported previously. Patients who were young or who had a favorable virologic response to lamivudine were more likely to have a sustained response.
authors.affiliation: Department of Hepatology, Osaka City University Medical School, Osaka 545-8585, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Enomoto
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tamori
authors.forename: Madoka Toyama
authors.initials: MT
authors.lastname: Kohmoto
authors.forename: Takehiro
authors.initials: T
authors.lastname: Hayashi
authors.forename: Hisato
authors.initials: H
authors.lastname: Jomura
authors.forename: Daiki
authors.initials: D
authors.lastname: Habu
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Takeda
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kawada
authors.forename: Shuichi
authors.initials: S
authors.lastname: Seki
authors.forename: Susumu
authors.initials: S
authors.lastname: Shiomi
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Koh
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005602:France; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D016899:Interferon-beta / Q000008:administration & dosage*; D019259:Lamivudine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage*
chemical_list: D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D016899:Interferon-beta