Randomised clinical trial: efficacy of peginterferon alfa-2a in HBeAg positive chronic hepatitis B patients with lamivudine resistance

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Randomised clinical trial: efficacy of peginterferon alfa-2a in HBeAg positive

chronic hepatitis B patients with lamivudine resistance

Alimentary Pharmacology and Therapeutics, 06/23/2011 Clinical Article

Sun J et al. – Overall, the response to peginterferon alfa–2a among patients

with lamivudine resistance was suboptimal. HBeAg seroconversion rate at week 72

by 48 weeks peginterferon alfa–2a treatment was higher than continuous

adefovir therapy. Monitoring HBsAg levels can help to predict response to

peginterferon alfa-2a.

Methods

• Chronic hepatitis B patients with lamivudine resistance were treated with

peginterferon alfa-2a for 48 weeks (n=55) or adefovir for 72 weeks (n=80) in

this randomised study.

• All enrolled patients were treated with lamivudine for the first 12 weeks.

Results• At 6 months posttreatment, 14.6% (18/123) of peginterferon

alfa-2a-treated patients achieved HBeAg seroconversion, in contrast to 3.8%

(3/80) of adefovir-treated patients after 72 weeks continuous therapy (P=0.01).

• For peginterferon alfa-2a-treated patients, the rate of HBeAg seroconversion

at week 72 was significantly higher in patients who had HBsAg decline >0.5 Log10

IU/mL from baseline at week 24, compared with patients with HBsAg decline ≤0.5

Log10 IU/mL from baseline at week 24 (25.5% vs. 7.7%, P=0.01).

• After 72 weeks continuous adefovir treatment, 22.5% of patients achieved HBV

DNA <80 IU/mL, compared with 10.6% in peginterferon alfa-2a-treated patients at

6 months off-treatment (P=0.02).