Chronic Hepatitis B Clinical Trial
Official title:
Long Term Follow-up of Pegylated-Interferon Alpha-2b and Lamivudine Combination Therapy in Patients With Chronic HBV Infection
The aim of this study was to investigate the long term outcome of Peginterferon alpha-2b with or without the addition of lamivudine in patients with chronic hepatitis B
Interferon alpha therapy is a generally accepted agent for the treatment of chronic HBV
infection and effective in about one third of patients. Recently, in the HBV 99-01 study,
pegylated interferon alpha-2b (PEG-IFN) has been shown to be effective in HBeAg-positive
patients with chronic hepatitis B. In this study, 266 patients were randomized to receive
PEG-IFN in combination with either lamivudine or placebo for 52 weeks.
Thirty-six percent of patients receiving monotherapy and thirty-five percent receiving
combination therapy had lost serum HBeAg at the end of the 26 week post-treatment follow-up
period and there was no difference between treatment groups (P = 0.91). More patients on
combination therapy initially seroconverted (44% of patients, compared with 29% on
monotherapy; P = 0.01) at the end of treatment but relapsed during follow-up. Similar
response patterns were seen when response was assessed by DNA suppression and change in ALT
levels.
In contrast to nucleoside analogues, such as lamivudine and adefovir dipivoxil, the
virological and biochemical response to standard alpha-interferon has been shown to be
durable after treatment discontinuation.In addition, standard alpha-interferon leads to
improved survival and reduction of hepatocellular carcinoma in chronic hepatitis B
patients.Pegylated interferons have shown to be effective in HBeAg-positive chronic
hepatitis B patients, but the durability of the response and long-term outcome of treatment
have yet to be established.
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Observational Model: Defined Population, Time Perspective: Longitudinal
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