Author/Authors :
MONTAZERI, G DIGESTIVE DISEASE RESEARCH CENTER - SHARLATL HOSPITAL - TEHRAN UNIVERSITY OF MEDICAL SCIENCES - TEHRAN, IRAN , MALEKZADEH, R DIGESTIVE DISEASE RESEARCH CENTER - SHARLATL HOSPITAL - TEHRAN UNIVERSITY OF MEDICAL SCIENCES - TEHRAN, IRAN , NOURI, N DIGESTIVE DISEASE RESEARCH CENTER - SHARLATL HOSPITAL - TEHRAN UNIVERSITY OF MEDICAL SCIENCES - TEHRAN, IRAN , SOHRABI, M.R DIGESTIVE DISEASE RESEARCH CENTER - SHARLATL HOSPITAL - TEHRAN UNIVERSITY OF MEDICAL SCIENCES - TEHRAN, IRAN , SOTOUDEH, M Departments of pathology shariati hospital - Tehran university of medical sciences , KAMALIAN, N Departments of pathology shariati hospital - Tehran university of medical sciences , FARHADI, M Departments of Hemalology - Tarbiat Modarres University Tehran
Abstract :
Background/Objective: To evaluate the efficacy of lamivudine alone and in combination with interferon in patients with chronic hepatitis B who were nonresponsive to previous interferon therapy.
Methods: Thirty-six adult patients, who were previously nonresponders to interferon, were randomly divided into two groups. Group I received lamivudine 100mg daily for nine months, and Group II received lamivudine 100mg daily for nine months in addition to interferon 5-10´106 u three times weekly for 6 months. Patients were followed up for another 6 months without receiving any medication.
The end points were; normalization of liver enzymes, sustained negative DNA and reduction of at least 2 points in the necroinfiammatory scores of the liver biopsies on the basis of the modified Knodell HAl system.
Results: In Group I, 55.6% had sustained negative DNA (P=0.001). The mean AST value of 75.22±64.14 ull before treatment decreased to 28.28±13.19 u/l after treatment (P=0.01). The mean ALT value of 104.22±92.96 u/l before treatment decreased to 31.22±20.10 u/l after treatment (P=0.005). The histological response was 38.8% (P=0.003). In Group 11, 38.9% had sustained negative viral DNA (0.004). The mean AST value of 67.29±53.07 prior to treatment decreased to 26.88±15.85 u/l after treatment (P=0.008). The mean ALT value of 98.24±75.92 u/l prior to treatment decreased to 28.06±21.53 u/l after treatment (P=0.002). The histological response rate was 27.7% (P=0.004). The P values were not significant comparing the post treatment AST, ALT, sustained negative HBV DNA and histological responses of the two groups.
Conclusions: It is concluded that both groups had a relatively good response rate with no statistically significant difference between the two groups. The adverse effect was more prevalent in Group II. It is suggested that chronic hepatitis B nonresponders to interferon should be treated with lamivudine therapy alone.
Keywords :
CHRONIC HEPATITIS B , LAMIVUDINE , INTERFERON , PRECORE MUTANTS
