Korean J Med.
2001 Apr;60(4):342-348.
Comparison of effect of interferon-alpha, lamivudine monotherapy and combination therapy in chronic hepatitis B
- Affiliations
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- 1Department of Internal Medicine, College of Medicine, DongGuk University, Kyong Ju, Korea.
- 2Department of Pharmacology, College of Medicine, DongGuk University, Kyong Ju, Korea.
- 3Department of Biochemistry, College of Oriental Medicine, DongGuk University, Kyong Ju, Korea. sujungil@hanmail.net
Abstract
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BACKGROUND: Alpha-interferon achieves HBeAg seroconversion in about 30 to 40% of patients with
chronic hepatitis B, and recently discovered lamivudine, an oral nucleoside analogue,
inhibits hepatitis B virus replication and reduces hepatic necroinflammation in patients
with chronic hepatitis B effectively. In this study, we compared the efficacy and safety
of alpha-interferon, lamivudine and their combination regimen.
METHODS
Fourty chronic hepatitis B patients, who were diagnosed through HBV DNA, HBeAg positivity, alanine aminotransferase elevation, and liver biopsy were enrolled in this study. Twelve patients were treated with 500 MU of alpha-interferon subcutaneously 3 times a week for 6 months, 9 patients were treated with 150 mg of lamivudine and alpha-interferon, and 19 patients were treated with 150 lamivudine daily for 6 months.
RESULTS
After treatment, all of the three groups showed rapid decline in HBV DNA level, but lamivudine group showed more clearance of HBV DNA than interferon group (alpha-interferon: 75%, combination group: 89%, lamivudine group: 100%, respectively) (p=0.04). HBeAg seroconversion rate was 25% for interferon group, 11% for combination group, 26% for lamivudine group, showing no difference between three groups (p=0.705). Mean serum ALT level and rate of ALT normalization during therapy showed no differnece (83% for interferon group, 78% for combination group, 84% for lamivudine group).
CONCLUSION
It is suggested that the efficacy of combination interferon/lamivudine therapy appears disappointing and further study should be done for appropriate combination or monotherapy of lamivudine for patients with chronic hepatitis B.
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