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Year 2013, Volume: 1 Issue: 1, 32 - 39, 25.03.2015

Rafet Mete , Mustafa Oran Kürşat Türkdoğan

Abstract

Aim This study aims to compare the efficacy of lamivudine (LAM) and interferon alpha (PEG-IFNα) monotherapies in HBeAg positive and HBeAg negative chronic hepatitis B. Materials and Methods This study was carried out between the years 2003 and 2007 at the Medicine Faculty of Yuzuncu Yil University (YYU). Totally, 61 patients, who applied to the Gastroentrolgy Clinic at YYU have been diagnosed as chronic hepatitis B, and their responses to the treatment were retrospectively analyzed. Whereas sixteen patients had HBeAg positive, 45 patients had HBeAg negative. Lamivudin (LAM) mono-therapy, an avarage 24.4 ± 2.3 months, has been given to the 34 patients (HBeAg positive=8, HBeAg negative=26), PEG-IFNα monoterapy, an avarage 12±0 months, has been given to the 27 patients (HBeAg positive=8, HBeAg negative=19) and both of the treatment groups have been followed 6 months after the treatment. Results There was no difference between groups for age (LAM: 39.8 years: PEG-IFNα:38.2 years, p>0.05). In each two treatment group, the differences among the rates of HBeAg positivity weren't statistically significant. There was no statistically significant difference between two treatment groups for HAI (Hepatic activity İndex) and FIB (Fibrosis) mean values (p>0.05). The levels of HBV DNA before treatment were accepted high if HbeAg positive patients have 105 copy/ml DNA and HbeAg negative patients have 104 copy/ml DNA. All of the patients have carried these criterions. The average ALT levels of the patients before the treatment were 129.0±15.5 and there was no statistically significant difference between two treatment groups for ALT (p>0,05). Conclusion Permanent viral response between LAM and PEG-IFNα treatments are similar. Both of the treatments have been successful when compared to the literature. We did not observe any differences between two treatment modality. We, also, believe that the shortness of the observation time after the treatment and the bad compliance of the patients to the treatment have affected the rate of the success of treatment

Keywords

Kronik Hepatitis B peg-IFN lamivudin

References

  • Eddleston ALWF, Dixon B. Interferons in treatment of chronic viral infection of the liver. 1st ed. UK: Pennine press; 1990;2:123-125.
  • Hadziyannis SJ.Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment.Viral Hep Rev 1995;1(1):7-36.
  • Naoumov NV, Schneider R, Groetzinger T, et al. Precore mutant hepatitis B virus infection and liver disease. Gastroenterology 1992;102(2):538-43.
  • Brunetto MR, Giarin E, Oliveri F et al. Wild-type and e antigen- minus Hepatitis B viruses and course of chronic USA.1991;88(10):4186-90. Natl Acad Sci
  • Dianzani F, Antonelli G, Capobianchi MR. The biological basis for the clinical use of interferon. J Hepatol 1990;11(1):5-10.
  • Rogers et al. Hepatitis B virus:clinical disease. Richard AW (ed).Viral Hepatitis,1st. edit, New York, Marcel Dekker 1997;1:134-46.
  • Janssen HL, van Zonneveld M, Senturk H, et al. Pegylated interferon alfa-2b alone or in combination with lamivudine for HbeAg-positive chronic hepatitis B: a randomised trial. Lancet 2005;365(9454):123-9.
  • Keeffe EB, Dieterich DT, Han SH, et al. A treatment algorithm for the management of chronic hepatitits B virus infection in the United States, Clin Gastroenterol Hepatol 2006;4(8):936-62.
  • Cooksley WG, Piratvisuth T, Lee SD, et al. Peg- interferon alpha-2a (40 kDa): an advance in the treath- ment of hepatitis B e antigen-positive chronic hepatitis B. J Viral Hepat 2003;10(4):298–305.
  • Perrillo RP.Therapy of hepatits B –viral suppression or eradication? Hepatology 2006;43(1):182-93.
  • Kaymakoğlu S, Çakaloğlu Y, Danalıoğlu A et al. Long
  • term results of alpha interferon monotherapy. J Hepatol 2003;38(2):149.
  • Cooksley WG, Piratvisuth T, Lee SD et al: Peginterferon alpha-2a (40kDa): an advance in the treatment of hepatitis B e antigen-positive chronic hepatitis B. J Viral Hepat 2003;10(4):298-305.
  • Mateos ML, Tato M, Moreira V. Lamivudine and adefovir resistance in a patient with HBeAg negative chronic 2006;29(2):71-3. Gastroenterol Hepatol.
  • Hadziyannis S, Lau GKK, Marcellin P, et al. Sustained HBsAg seroconversion in patients with chronic hepatitis B treated with peginterferon alfa-2a (40KD) (PEGASYS®). J Hepatol 2005;42(2):178.
  • Marcellin P, Lau GKK, Bonino F et al. Peginterferon alfa-2a alone, lamivudine alone, and the two in combination in patients with HbeAgnegative chronic hepatitis B, N Engl J Med 2004;351(12):1206-17.
  • Dienstag JL, Schiff E, Wright T, et al. Lamivudine as initial treatment for chronic hepatitis B in the United States .N Engl J Med 1999;341(17):1256-1263.
  • Lai CL ,Chien RN ,Leung NW , et al. A one year trial of Lamivudine for chronic hepatitis B. Asia Hepatitis Lamivudine 1998;339(2):61-8. Engl J Med
  • Leung NW, Lai CL, Chang TT, et al. Extended lamivudine treatment in patients witchronic hepatitis B enhances hepatitis B e antigen seroconversiyon rates: results after 3 years of therapy. Hepatology .2001;33(6):1527-153.
  • Tassopoulos NC, Volpes R, Pastore G et al. Efficacy of lamivudine in ptients with hepatitis B e antigen– negative/hepatitis B virus DNA-positive (precore mutant) chronic hepatitis B. Lamivudine Precore Mutant Study Group.Hepatology .1999;29(3):889-896.
  • Chien RN, Liaw YF, Akins M et al. Pretherapy ALT level as a determinant for hepatitis B and antigen seroconversiyon during lamivudine therapy in patients with chronic hepatitis B. Asian Lamivudine Trial group. Hepatoloğy 1999;30(3):770-4.
  • Guan R, Lai CL, Liaw YF et al. Efficacy and safety of 5 year lamivudine treatment of Chineese patients with chronic hepatitis B. J Gastroenterol Hepatol 2001;16:60-61.
  • Liaw YF. Results of Lamuvidine trials in Asia. J Hepatol 2003;39(1):111-5.
  • Lai CL, Shouval D, Lok AS et al: Entecavir versus lamivudine for patients with HbeAg-negative chronic hepatitis B, N Engl J Med 2006;354(10):1011-20.
  • Shouval D, Lai CL, Cheinquer H, et al: Entecavir demonstrates superior histologic and virologic eficacy over lamivudine in nucleoside-naive HbeAg(-) chronic hepatitis B: results of phase III trial. Hepatology 2004;40(1):728

Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa ile Lamivudin Monoterapilerinin Karşılaştırılması

Year 2013, Volume: 1 Issue: 1, 32 - 39, 25.03.2015

Rafet Mete , Mustafa Oran Kürşat Türkdoğan

Abstract

Amaç: Bu çalışmada, HBeAg pozitif ve HBeAg negatif kronik hepatit B hastalarında Lamivudin (LAM) monoterapisi ile Pegile-interferon alfa (PEG-IFNα) monoterapisi etkinliklerinin karşılaştırılması amaçlanmıştır.

Materyal ve Metod: Bu çalışmaya 2003-2007 yılları arasında Yüzüncü Yıl Üniversitesi Tıp Fakültesi Gastroenteroloji kliniğine başvuran ve kronik hepatit B infeksiyonu tanısı konup tedavi edilen toplam 61 hastanın tedaviye cevapları retrospektif olarak incelendi.16 hasta HBeAg pozitif, 45 hasta HBe Ag negatifti. 34 hastaya (HBeAg-pozitif = 8, HBeAg-negatif= 26) Lamivudin (LAM) monoterapisi ortalama 24.4±2.3 ay ve 27 hastaya (HBeAg-pozitif = 8, HBeAg-negatif = 19) Pegileinterferon alfa (PEG-IFNα) monoterapisi 12±0 ay verildi ve her iki grup tedavi sonrası 6 ay izlendi.


Bulgular: İki tedavi grubu için yaşlar arasında istatistiksel olarak fark yoktu (LAM grubu:39.8, PEG-IFNα:38.2, p>0,05 ). Her iki tedavi grubunda HBeAg pozitifliği oranları arasında fark istatistik olarak anlamlı değildi (p>0,05). iki tedavi grubu arasında HAİ ve FİB özelliklerinin ortancaları (Medyanları) arasında istatistiksel olarak anlamlı fark yoktu (p>0,05). Tedavi öncesi HBV DNA düzeyleri; HBeAg pozitif hastalarda 105 kopy/ml, negatiflerde 104 kopy/ml den yüksek olan tüm hastalar tedavi kriteri taşımaktaydı. Tedavi öncesi hastaların ortalama ALT düzeyi 129.0±15,5 olup başlangıçtaki ALT ortalamaları iki grup arasında farklı değildi (p>0,05).


Sonuç: LAM ve PEG-IFNα tedavileri arasında kalıcı cevap benzerdir ve gruplar arasında istatistik olarak fark oluşturmamıştır Literatürle karşılaştırıldığında bu çalışmada başarı oranı daha fazla olmakla beraber anlamlı fark yoktu. Başarı oranımızdaki bu yüksekliği tedavi sonu izlem süremizin kısa olması ve hasta uyumunun tam olmasından kaynaklandığına bağlayabiliriz.

Keywords

Kronik Hepatit B peg-IFN lamivudin

References

  • Eddleston ALWF, Dixon B. Interferons in treatment of chronic viral infection of the liver. 1st ed. UK: Pennine press; 1990;2:123-125.
  • Hadziyannis SJ.Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment.Viral Hep Rev 1995;1(1):7-36.
  • Naoumov NV, Schneider R, Groetzinger T, et al. Precore mutant hepatitis B virus infection and liver disease. Gastroenterology 1992;102(2):538-43.
  • Brunetto MR, Giarin E, Oliveri F et al. Wild-type and e antigen- minus Hepatitis B viruses and course of chronic USA.1991;88(10):4186-90. Natl Acad Sci
  • Dianzani F, Antonelli G, Capobianchi MR. The biological basis for the clinical use of interferon. J Hepatol 1990;11(1):5-10.
  • Rogers et al. Hepatitis B virus:clinical disease. Richard AW (ed).Viral Hepatitis,1st. edit, New York, Marcel Dekker 1997;1:134-46.
  • Janssen HL, van Zonneveld M, Senturk H, et al. Pegylated interferon alfa-2b alone or in combination with lamivudine for HbeAg-positive chronic hepatitis B: a randomised trial. Lancet 2005;365(9454):123-9.
  • Keeffe EB, Dieterich DT, Han SH, et al. A treatment algorithm for the management of chronic hepatitits B virus infection in the United States, Clin Gastroenterol Hepatol 2006;4(8):936-62.
  • Cooksley WG, Piratvisuth T, Lee SD, et al. Peg- interferon alpha-2a (40 kDa): an advance in the treath- ment of hepatitis B e antigen-positive chronic hepatitis B. J Viral Hepat 2003;10(4):298–305.
  • Perrillo RP.Therapy of hepatits B –viral suppression or eradication? Hepatology 2006;43(1):182-93.
  • Kaymakoğlu S, Çakaloğlu Y, Danalıoğlu A et al. Long
  • term results of alpha interferon monotherapy. J Hepatol 2003;38(2):149.
  • Cooksley WG, Piratvisuth T, Lee SD et al: Peginterferon alpha-2a (40kDa): an advance in the treatment of hepatitis B e antigen-positive chronic hepatitis B. J Viral Hepat 2003;10(4):298-305.
  • Mateos ML, Tato M, Moreira V. Lamivudine and adefovir resistance in a patient with HBeAg negative chronic 2006;29(2):71-3. Gastroenterol Hepatol.
  • Hadziyannis S, Lau GKK, Marcellin P, et al. Sustained HBsAg seroconversion in patients with chronic hepatitis B treated with peginterferon alfa-2a (40KD) (PEGASYS®). J Hepatol 2005;42(2):178.
  • Marcellin P, Lau GKK, Bonino F et al. Peginterferon alfa-2a alone, lamivudine alone, and the two in combination in patients with HbeAgnegative chronic hepatitis B, N Engl J Med 2004;351(12):1206-17.
  • Dienstag JL, Schiff E, Wright T, et al. Lamivudine as initial treatment for chronic hepatitis B in the United States .N Engl J Med 1999;341(17):1256-1263.
  • Lai CL ,Chien RN ,Leung NW , et al. A one year trial of Lamivudine for chronic hepatitis B. Asia Hepatitis Lamivudine 1998;339(2):61-8. Engl J Med
  • Leung NW, Lai CL, Chang TT, et al. Extended lamivudine treatment in patients witchronic hepatitis B enhances hepatitis B e antigen seroconversiyon rates: results after 3 years of therapy. Hepatology .2001;33(6):1527-153.
  • Tassopoulos NC, Volpes R, Pastore G et al. Efficacy of lamivudine in ptients with hepatitis B e antigen– negative/hepatitis B virus DNA-positive (precore mutant) chronic hepatitis B. Lamivudine Precore Mutant Study Group.Hepatology .1999;29(3):889-896.
  • Chien RN, Liaw YF, Akins M et al. Pretherapy ALT level as a determinant for hepatitis B and antigen seroconversiyon during lamivudine therapy in patients with chronic hepatitis B. Asian Lamivudine Trial group. Hepatoloğy 1999;30(3):770-4.
  • Guan R, Lai CL, Liaw YF et al. Efficacy and safety of 5 year lamivudine treatment of Chineese patients with chronic hepatitis B. J Gastroenterol Hepatol 2001;16:60-61.
  • Liaw YF. Results of Lamuvidine trials in Asia. J Hepatol 2003;39(1):111-5.
  • Lai CL, Shouval D, Lok AS et al: Entecavir versus lamivudine for patients with HbeAg-negative chronic hepatitis B, N Engl J Med 2006;354(10):1011-20.
  • Shouval D, Lai CL, Cheinquer H, et al: Entecavir demonstrates superior histologic and virologic eficacy over lamivudine in nucleoside-naive HbeAg(-) chronic hepatitis B: results of phase III trial. Hepatology 2004;40(1):728
There are 25 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Araştırma Makaleleri
Authors

Rafet Mete

Mustafa Oran This is me

Kürşat Türkdoğan This is me

Publication Date March 25, 2015
Published in Issue Year 2013 Volume: 1 Issue: 1

Cite

APA Mete, R., Oran, M., & Türkdoğan, K. (2015). Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa ile Lamivudin Monoterapilerinin Karşılaştırılması. International Journal of Basic and Clinical Medicine, 1(1), 32-39.
AMA Mete R, Oran M, Türkdoğan K. Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa ile Lamivudin Monoterapilerinin Karşılaştırılması. International Journal of Basic and Clinical Medicine. March 2015;1(1):32-39.
Chicago Mete, Rafet, Mustafa Oran, and Kürşat Türkdoğan. “Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa Ile Lamivudin Monoterapilerinin Karşılaştırılması”. International Journal of Basic and Clinical Medicine 1, no. 1 (March 2015): 32-39.
EndNote Mete R, Oran M, Türkdoğan K (March 1, 2015) Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa ile Lamivudin Monoterapilerinin Karşılaştırılması. International Journal of Basic and Clinical Medicine 1 1 32–39.
IEEE R. Mete, M. Oran, and K. Türkdoğan, “Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa ile Lamivudin Monoterapilerinin Karşılaştırılması”, International Journal of Basic and Clinical Medicine, vol. 1, no. 1, pp. 32–39, 2015.
ISNAD Mete, Rafet et al. “Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa Ile Lamivudin Monoterapilerinin Karşılaştırılması”. International Journal of Basic and Clinical Medicine 1/1 (March 2015), 32-39.
JAMA Mete R, Oran M, Türkdoğan K. Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa ile Lamivudin Monoterapilerinin Karşılaştırılması. International Journal of Basic and Clinical Medicine. 2015;1:32–39.
MLA Mete, Rafet et al. “Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa Ile Lamivudin Monoterapilerinin Karşılaştırılması”. International Journal of Basic and Clinical Medicine, vol. 1, no. 1, 2015, pp. 32-39.
Vancouver Mete R, Oran M, Türkdoğan K. Kronik Hepatit B Tedavisinde Pegile İnterferon Alfa ile Lamivudin Monoterapilerinin Karşılaştırılması. International Journal of Basic and Clinical Medicine. 2015;1(1):32-9.
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