AI Summary & Key Takeaways
AI InsightConclusions: The patients with breakthrough infection during lamivudine treatment, which was combined with interferon at the beginning, may benefit from another cycle of interferon treatment.
📌 3 Key Takeaways
Abstract
Background/aims: The most important problem of the lamivudine therapy is the frequent development of drug resistance. Treatment of chronic hepatitis B patients resistant to lamivudin remains to be established. We investigated in this study the efficacy of interferon therapy for breakthrough infection to combination therapy with interferon and lamivudine. Methods: Interferon therapy was applied to nine patients who experienced HBV DNA breakthrough with ALT elevation for at least three months during the lamivudine treatment, which was given in combination with interferon for the first six months. These patients were compared with 10 patients who developed breakthrough but were not given interferon. All the patients continued to receive lamivudine. Results: Of the nine patients who were given interferon, two lost HBV DNA and had normal ALT after six months of treatment. ALT levels returned to normal in two patients who had no virological response. Of those patients not given interferon, none lost HBV DNA, but th ree had normal ALT at the end of the same duration of follow-up. Conclusions: The patients with breakthrough infection during lamivudine treatment, which was combined with interferon at the beginning, may benefit from another cycle of interferon treatment.
Özet
Amaç: Lamivudin tedavisinde en önemli problem sıklıkla ilaca karşı direnç gelişmesidir. Lamivudine dirençli hepatit B olgularının nasıl tedavi edileceği bilinmemektedir. Bu çalışmada interferon lamivudin kombinasyon tedavisi sırasında breakthrough infeksiyon gelişen olgularda yeniden interferon tedavisinin etkinliği araştırılmıştır. Yöntem: İlk 6 ay interferonla kombine, daha sonra yalnız lamivudine kullanırken en az 3 aydır ALT yüksekliği ve HBV DNA pozitifliği (Breakthrough infeksiyon) gelişen 9 hastaya interferon tedavisi uygulandı. Bu hastaların sonuçları breakthrough infeksiyon gelişen interferon verilmeyen 10 hasta ile karşılaştırıldı. Bütün hastalar lamivudine almaya devam etti. Bulgular: 6 ay interferon alan 9 hastanın 2'inde HBV DNA kayboldu, ALT normal değerlerlere düştü. Ayrıca virolojik cevap vermeyen 2 hastada ALT değerleri normal değerlere indi. interferon verilmeyen hastaların hiçbirinde HBV DNA kaybı olmadı, fakat 3'ünde aynı takip süresinde ALT değerleri normal düzeylere düştü. Sonuç: Başlangıçta interferon ile kombine edilen, lamivudin tedavisi sırasında breakthrough infeksiyonlu hastalar tekrar interferon tedavisinden yarar görebilirler.