title: Long-Term Outcome of Sequential Therapy with Lamivudine Followed by Interferon-β in Nucleoside-Naive, Hepatitis B e-Antigen-Positive Patients with Chronic Hepatitis B Virus Genotype C Infection.
abstract: It is unclear whether the combination of a nucleos(t)ide analog and interferon (IFN) is superior to monotherapy for treating chronic hepatitis B. In this study, we report the long-term outcomes of sequential therapy using lamivudine followed by IFN-β. This study included 24 hepatitis B e-antigen (HBeAg)-positive patients with chronic hepatitis B virus (HBV) genotype C infection who were treated with lamivudine alone for 16-32 weeks, then with both IFN-β and lamivudine for 4 weeks, and finally with IFN-β alone for 20 weeks. All patients were followed up for 7.1±2.8 years post-treatment. The rate of response, defined as transaminase normalization, HBeAg loss, and HBV DNA <10(4) copies/mL, was 5/24 (21%) at 24 weeks post-treatment. The patients with short-term responses were younger than those with no response (P=0.039). More short-term responders had undetectable HBV DNA at the start of IFN-β compared with the nonresponders (P=0.0059). Subsequently, 4 of the 5 short-term responders remained free of the need for further drug treatment for 4.2±3.5 years post-treatment; more short-term responders remained drug free than did nonresponders (P=0.035). In conclusion, the rate of response to sequential therapy was limited in HBeAg-positive patients with chronic HBV genotype C infection at 24 weeks post-treatment. In the majority of the short-term responders, however, the response was sustainable in the long term.
authors.affiliation: 1 Department of Hepatology, Osaka City University Medical School , Osaka, Japan .
authors.forename: Masaru
authors.initials: M
authors.lastname: Enomoto
authors.affiliation: 2 Department of Internal Medicine, Hyogo College of Medicine , Nishinomiya, Japan .
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
authors.affiliation: 1 Department of Hepatology, Osaka City University Medical School , Osaka, Japan .
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tamori
authors.affiliation: 1 Department of Hepatology, Osaka City University Medical School , Osaka, Japan .
authors.forename: Ritsuzo
authors.initials: R
authors.lastname: Kozuka
authors.affiliation: 1 Department of Hepatology, Osaka City University Medical School , Osaka, Japan .
authors.forename: Takehiro
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: 1 Department of Hepatology, Osaka City University Medical School , Osaka, Japan .
authors.forename: Madoka Toyama
authors.initials: MT
authors.lastname: Kohmoto
authors.affiliation: 3 Department of Internal Medicine, Wakakoukai Clinic , Osaka, Japan .
authors.forename: Hisato
authors.initials: H
authors.lastname: Jomura
authors.affiliation: 1 Department of Hepatology, Osaka City University Medical School , Osaka, Japan .
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Morikawa
authors.affiliation: 1 Department of Hepatology, Osaka City University Medical School , Osaka, Japan .
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Murakami
authors.affiliation: 4 Department of Nuclear Medicine, Osaka City University Medical School , Osaka, Japan .
authors.forename: Susumu
authors.initials: S
authors.lastname: Shiomi
authors.affiliation: 1 Department of Hepatology, Osaka City University Medical School , Osaka, Japan .
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kawada
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006512:Hepatitis B Core Antigens / Q000097:blood / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000276:immunology; D006513:Hepatitis B e Antigens / Q000097:blood / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D006801:Humans; D016899:Interferon-beta / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D019259:Lamivudine; D016899:Interferon-beta