Sequential combination therapy of HBe antigen-negative/virus-DNA-positive chronic hepatitis B with famciclovir or lamivudine and interferon-alpha-2a

[Guest guest]

Liver International

Volume 24 Issue 2 Page 98 - April 2004

doi:10.1111/j.1478-3231.2004.0889.x

Clinical Studies

Sequential combination therapy of HBe antigen-negative/virus-DNA-positive

chronic hepatitis B with famciclovir or lamivudine and interferon-alpha-2a

Ingolf Schiefke1, Klecker2, Maier2, Ute Oesen4, Gunnar

Etzrodt1, Tannapfel3, Uwe G. Liebert2, Frieder Berr1,5

Background/Aims: Hepatitis B e antigen-negative/hepatitis B virus (HBV)

DNA-positive chronic hepatitis B (CHBe) exhibits a high relapse rate on

monotherapy with lamivudine or interferon-alpha (IFN-). We investigated,

whether sequential therapy with famciclovir or lamivudine followed by

combination with IFN--2a improves durable virologic response in CHBe

characterized by mutation analysis of the HBV precore genome region.

Methods: Fourteen patients were treated with famciclovir (n=3) or lamivudine

for 4 weeks to reduce the viral load, and subsequently with the combination

of the nucleoside analogue and IFN--2a until 16 weeks beyond the loss of

serum HBV-DNA.

Results: Median duration of therapy was 29.0 weeks (range 20.6-48.3 weeks).

Serum HBV-DNA was undetectable and alanine aminotransferase had normalized

in all patients at the end of treatment. Seven (50%) patients maintained a

sustained response 12 months after end of treatment. Only two of them had

been infected by HBV with the G1896A mutation. Most patients (5/7) with the

G1896A mutation relapsed within 4 months after therapy.

Conclusion: Sequential combination therapy can induce sustained virologic

response in a subgroup of CHBe, but most with the G1896A precore mutant HBV

relapse. Trials of CHBe should be based on characterization of HBV mutants.

[Guest guest]

Liver International

Volume 24 Issue 2 Page 98 - April 2004

doi:10.1111/j.1478-3231.2004.0889.x

Clinical Studies

Sequential combination therapy of HBe antigen-negative/virus-DNA-positive

chronic hepatitis B with famciclovir or lamivudine and interferon-alpha-2a

Ingolf Schiefke1, Klecker2, Maier2, Ute Oesen4, Gunnar

Etzrodt1, Tannapfel3, Uwe G. Liebert2, Frieder Berr1,5

Background/Aims: Hepatitis B e antigen-negative/hepatitis B virus (HBV)

DNA-positive chronic hepatitis B (CHBe) exhibits a high relapse rate on

monotherapy with lamivudine or interferon-alpha (IFN-). We investigated,

whether sequential therapy with famciclovir or lamivudine followed by

combination with IFN--2a improves durable virologic response in CHBe

characterized by mutation analysis of the HBV precore genome region.

Methods: Fourteen patients were treated with famciclovir (n=3) or lamivudine

for 4 weeks to reduce the viral load, and subsequently with the combination

of the nucleoside analogue and IFN--2a until 16 weeks beyond the loss of

serum HBV-DNA.

Results: Median duration of therapy was 29.0 weeks (range 20.6-48.3 weeks).

Serum HBV-DNA was undetectable and alanine aminotransferase had normalized

in all patients at the end of treatment. Seven (50%) patients maintained a

sustained response 12 months after end of treatment. Only two of them had

been infected by HBV with the G1896A mutation. Most patients (5/7) with the

G1896A mutation relapsed within 4 months after therapy.

Conclusion: Sequential combination therapy can induce sustained virologic

response in a subgroup of CHBe, but most with the G1896A precore mutant HBV

relapse. Trials of CHBe should be based on characterization of HBV mutants.

[Guest guest]

Liver International

Volume 24 Issue 2 Page 98 - April 2004

doi:10.1111/j.1478-3231.2004.0889.x

Clinical Studies

Sequential combination therapy of HBe antigen-negative/virus-DNA-positive

chronic hepatitis B with famciclovir or lamivudine and interferon-alpha-2a

Ingolf Schiefke1, Klecker2, Maier2, Ute Oesen4, Gunnar

Etzrodt1, Tannapfel3, Uwe G. Liebert2, Frieder Berr1,5

Background/Aims: Hepatitis B e antigen-negative/hepatitis B virus (HBV)

DNA-positive chronic hepatitis B (CHBe) exhibits a high relapse rate on

monotherapy with lamivudine or interferon-alpha (IFN-). We investigated,

whether sequential therapy with famciclovir or lamivudine followed by

combination with IFN--2a improves durable virologic response in CHBe

characterized by mutation analysis of the HBV precore genome region.

Methods: Fourteen patients were treated with famciclovir (n=3) or lamivudine

for 4 weeks to reduce the viral load, and subsequently with the combination

of the nucleoside analogue and IFN--2a until 16 weeks beyond the loss of

serum HBV-DNA.

Results: Median duration of therapy was 29.0 weeks (range 20.6-48.3 weeks).

Serum HBV-DNA was undetectable and alanine aminotransferase had normalized

in all patients at the end of treatment. Seven (50%) patients maintained a

sustained response 12 months after end of treatment. Only two of them had

been infected by HBV with the G1896A mutation. Most patients (5/7) with the

G1896A mutation relapsed within 4 months after therapy.

Conclusion: Sequential combination therapy can induce sustained virologic

response in a subgroup of CHBe, but most with the G1896A precore mutant HBV

relapse. Trials of CHBe should be based on characterization of HBV mutants.

[Guest guest]

Liver International

Volume 24 Issue 2 Page 98 - April 2004

doi:10.1111/j.1478-3231.2004.0889.x

Clinical Studies

Sequential combination therapy of HBe antigen-negative/virus-DNA-positive

chronic hepatitis B with famciclovir or lamivudine and interferon-alpha-2a

Ingolf Schiefke1, Klecker2, Maier2, Ute Oesen4, Gunnar

Etzrodt1, Tannapfel3, Uwe G. Liebert2, Frieder Berr1,5

Background/Aims: Hepatitis B e antigen-negative/hepatitis B virus (HBV)

DNA-positive chronic hepatitis B (CHBe) exhibits a high relapse rate on

monotherapy with lamivudine or interferon-alpha (IFN-). We investigated,

whether sequential therapy with famciclovir or lamivudine followed by

combination with IFN--2a improves durable virologic response in CHBe

characterized by mutation analysis of the HBV precore genome region.

Methods: Fourteen patients were treated with famciclovir (n=3) or lamivudine

for 4 weeks to reduce the viral load, and subsequently with the combination

of the nucleoside analogue and IFN--2a until 16 weeks beyond the loss of

serum HBV-DNA.

Results: Median duration of therapy was 29.0 weeks (range 20.6-48.3 weeks).

Serum HBV-DNA was undetectable and alanine aminotransferase had normalized

in all patients at the end of treatment. Seven (50%) patients maintained a

sustained response 12 months after end of treatment. Only two of them had

been infected by HBV with the G1896A mutation. Most patients (5/7) with the

G1896A mutation relapsed within 4 months after therapy.

Conclusion: Sequential combination therapy can induce sustained virologic

response in a subgroup of CHBe, but most with the G1896A precore mutant HBV

relapse. Trials of CHBe should be based on characterization of HBV mutants.