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AIM:To study the role of lamivudine in improving theefficiency of interferon for the treatment of mutant typechronic hepatitis B.METHODS:Fifteen patients with mutant type chronichepatitis B were prospectively studied.All patients had liverhistology and serology to prove the diagnosis of chronichepatitis B.Each patient received 4.5 millionunits ofinterferon alpha-2a thrice weekly and 100 mg of orallamivudine daily for 24 weeks.Patients were observed andtested for blood chemistry every week for the initial 4 weeksand every 2 weeks thereafter during the treatment until 24weeks.After the end of treatment,patients were followedup at 4-week intervals for an additional 6 months.SerumHBV DNA levels were tested using the liquid phase molecularhybridization assay.Those with non-detectable HBV DNAwere also tested using the real-time polymerase chainreaction.One patient,who did not finish treatment due todepression,was excluded.RESULTS:At the end of treatment,7(50 %)patients hadserum ALT levels within normal limits;12(86 %)patientshad serum HBV DNA levels<5 pg/mL using the liquid phasemolecular hybridization assay,but only 8(67%)were<20copies/dL using the real-time polymerase chain reaction.Six months after treatment,only two(14 %)patients had asustained complete response to the combination therapywith serum ALT level<35 iu/L and undetectable serum HBVDNA Levels.CONCLUSION: These pilot data showed that lamivudine did not increase the efficacy of interferon in the treatment of mutant type chronic hepatitis B. The liquid phase molecular hybridization assay was not sensitive enough to detect the low HBV DNA levels during combined interferon and lamivudine therapy.
AIM: To study the role of lamivudine in improving the efficiency of interferon for the treatment of mutant type chronic hepatitis B. METHODS: Fifteen patients with mutant type chronic hepatitis B were prospectively studied. All patients had liverhistology and serology to prove the diagnosis of chronic hepatitis. patients received 4.5 millionunits ofinterferon alpha-2a thrice weekly and 100 mg of orallamivudine daily for 24 weeks. Patients were observed andtested for blood chemistry every week for the initial 4 weeksand every 2 weeks thereafter during the treatment until 24 weeks. After the end of treatment, patients were followed up at 4-week intervals for an additional 6 months. Serum HBV DNA levels were tested using the liquid phase molecular hybridization assay. Tose with non-detectable HBV DNAwere also tested using the real-time polymerase chain reaction. Ten patient, who did not finish treatment due todepression, was excluded.RESULTS: At the end of treatment, 7 (50%) patients hadserum ALT levels wi 12 (86%) patientshad serum HBV DNA levels <5 pg / mL using the liquid phase molecular hybridization assay, but only 8 (67%) were <20copies / dL using the real-time polymerase chain reaction. treatment, only two (14%) patients had asustained complete response to the combination therapy with serum ALT level <35 iu / L and undetectable serum HBVDNA Levels.CONCLUSION: These pilot data showed that lamivudine did not increase the efficacy of interferon in the treatment of mutant type chronic hepatitis B. The liquid phase molecular hybridization assay was not sensitive enough to detect the low HBV DNA levels during combined interferon and lamivudine therapy.