Interferon/long-term lamivudine combination therapy in anti-HBe positive chronic hepatitis B patients

  1. NIKOLAOS L NIKOLAIDIS1,*,
  2. OLGA I GIOULEME1,
  3. KONSTANTINOS A TZIOMALOS1,
  4. ADAMOS S SAVERIADIS1,
  5. NIKOLAOS GRAMMATIKOS1,
  6. PANAGIOTIS DOUKELIS1,
  7. ANASTASIOS D VOUTSAS1,
  8. THEMISTOKLIS VASSILIADIS1,
  9. KALLIOPI PATSIAOURA2,
  10. ELENI ORFANOU-KOUMERKERIDOU3,
  11. AIKATERINI BALASKA1,
  12. NIKOLAOS P EUGENIDIS1

Article first published online: 12 OCT 2005

DOI: 10.1111/j.1440-1746.2005.04029.x

Issue

Journal of Gastroenterology and Hepatology

Journal of Gastroenterology and Hepatology

Volume 20, Issue 11, pages 1721–1725, November 2005

Additional Information

How to Cite

NIKOLAIDIS, N. L., GIOULEME, O. I., TZIOMALOS, K. A., SAVERIADIS, A. S., GRAMMATIKOS, N., DOUKELIS, P., VOUTSAS, A. D., VASSILIADIS, T., PATSIAOURA, K., ORFANOU-KOUMERKERIDOU, E., BALASKA, A. and EUGENIDIS, N. P. (2005), Interferon/long-term lamivudine combination therapy in anti-HBe positive chronic hepatitis B patients. Journal of Gastroenterology and Hepatology, 20: 1721–1725. doi: 10.1111/j.1440-1746.2005.04029.x

Author Information

  1. 1

    Gastroenterology and Hepatology Section of Second Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki

  2. 2

    Department of Pathology

  3. 3

    Fourth Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece

*Nikolaos Nikolaidis, 49 Konstantinoupoleos Street, Thessaloniki, 54642, Greece. Email: niknik@med.auth.gr

Publication History

  1. Issue published online: 12 OCT 2005
  2. Article first published online: 12 OCT 2005
  3. Accepted for publication 18 November 2004.

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Keywords:

  • anti-HBe positive chronic hepatitis B;
  • combination therapy;
  • lamivudine resistance

Abstract

Background:  Monotherapy with a single antiviral agent is insufficient in controlling hepatitis B virus infection in the majority of patients with anti-HBe positive chronic hepatitis B. Interferon/long-term lamivudine combination therapy was evaluated to determine if this strategy would improve treatment efficacy and reduce the emergence of lamivudine resistance.

Methods:  In total, 36 consecutive anti-HBe positive patients were treated with interferon (3 MU subcutaneously three times weekly) and lamivudine (100 mg orally once a day) for 12 months. After completion of the combined treatment, all patients continued to receive lamivudine monotherapy indefinitely.

Results:  Overall, 35 patients (97%) showed virological response at 12 months. Four patients (11%) cleared HBsAg and developed anti-HBs. During the follow-up time, after the discontinuation of interferon, of 30 ± 12 months (range: 7–57 months), 13 patients (36%) exhibited breakthrough infection. The cumulative rates of breakthrough infection at the end of 1, 2, 3 and 4 years of treatment were 0%, 14%, 32%, and 59%, respectively.

Conclusions:  Combination therapy appears to be effective and may also delay the selection of lamivudine-resistant variants. However, controlled trials are definitely warranted to clarify the potential benefits of combination antiviral treatment over monotherapy.

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