Lamivudine monotherapy, interferon alpha monotherapy and combination therapy in chronic hepatitis B infection

Yıl 2006, Cilt: 5 Sayı: 1, 31 - 35, 01.04.2006

Necati Yenice Özgür Mehtap Nurten Arıcan Yasemin Gökden

Öz

Background/aim: This study aims to evaluate the efficacy of lamivudine and interferon alpha monotherapies and their combination in HBeAgpositive and HBeAg-negative chronic hepatitis B. Materials and methods: Between 2002 and 2004, a total of 128 patients [65 HBeAgpositive and 63 HBeAg-negative] were enrolled; 21 patients received lamivudine monotherapy (HBeAg-positive = 11, HBeAg-negative = 10), 40 received interferon-alpha monotherapy (HBeAg-positive = 23, HBe- Ag-negative = 17), and 67 received the combination (HBeAg-positive = 29, HBeAg-negative = 38). The virologic responses, biochemical responses, and seroconversion rates were evaluated after 6 months. Results: In HBeAg-positive patients, HBV DNA loss was observed in 36.4%, 47.8% and 89.7% of patients after lamivudine monotherapy, interferon monotherapy and combination therapy, respectively (p

Anahtar Kelimeler

Chronic hepatitis B, lamivudine, interferon, combination, precore mutant

Kronik hepatit B enfeksiyonunda lamivudin monoterapisi, interferon alfa monoterapisi ve kombinasyon tedavisi

Öz

Giriş ve amaç: Bu çalışmada, HBeAg pozitif ve HBeAg negatif kronik
hepatit B hastalarında lamivudin monoterapisi, interferon alfa monoterapisi
ve bunların kombinasyonunun etkinliklerinin değerlendirilmesi
amaçlanmıştır. Gereç ve yöntem: 2002 ve 2004 yılları arasında çalışmaya
toplam 128 hasta alınmış [65 HBeAg-pozitif ve 63 HBeAg-negatif];
21 hastaya lamivudin monoterapisi (HBeAg-pozitif = 11, HBeAg-negatif
= 10); 40 hastaya interferon alfa monoterapisi (HBeAg-pozitif = 23,
HBeAg-negatif = 17) ve 67 hastaya (HBeAg-pozitif = 29, HBeAg-negatif
= 38) kombinasyon tedavisi verilmiştir. Lamivudin monoterapisi alan
hastalara beş yıl, interferon monoterapisi ve kombinasyon tedavisi alan
gruba bir yıl takip ve tedavi düzenlenmiştir. Hastaların tedavi altında
iken altıncı aydaki virolojik yanıtlar, biyokimyasal yanıtlar ve serokonversiyon
oranları değerlendirilmiştir. Bulgular: HBeAg pozitif hastalarda,
lamuvidin monoterapisi ile hastaların %36.4’ünde, interferon monoterapisi
ile %47.8’inde ve kombinasyon tedavisi ile %89.7’sinde HBV
DNA kaybı gözlenmiştir. (p < 0.01, kombinasyon tedavisi lamivudin ve
interferon ile karşılaştırıldığına). Tedavi grupları arasında serokonversiyon
ve ALT normalizasyon oranları açısıdan anlamlı fark yoktur. HBeAg-negatif
hastalarda ise HBV DNA kaybı ve serokonversiyon oranları
açısıdan tedavi grupları arasında anlamlı hiçbir fark bulunmamıştır.
Sonuç: Erken sonuçlarımız lamivudin-interferon kombinasyonunun, tek
başına lamivudin ya da interferon ile karşılaştırıldığında, HBeAg pozitif
hastalarda daha yüksek virolojik yanıtlar sağlayabileceğini göstermektedir.
Ancak prekor mutant vakalarda kombinasyon lehine böyle bir farklılık
gözlenmemiştir.

Anahtar Kelimeler

Kronik hepatit B, lamivudin, interferon, kombinasyon, prekor mutant

Kaynakça

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