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KMID : 0882420030650060638
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Korean Journal of Medicine
2003 Volume.65 No. 6 p.638 ~ p.644
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A comparative study on the efficacy between interferon alpha monotherapy and lamivudine-interferon combination therapy in chronic hepatitis B patients
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Lim Tae-Hyung
Jeong Dong-Seong
Lee Sang
Han Seung-Ho
Kum Dong-Sung
Joo Hee-RIn
Jang Jin-Seok
Lee Jong-Hoon
Roh Myung-Hwan
Han Sang-Young
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Abstract
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Background : At present, lamivudine-interferon combination therapy is being tried on chronic
hepatitis B patients who had no significant response to interferon-alpha mono-therapy. The
therapeutic effect of lamivudine-interferon combination therapy is showing various outcomes
depending on the period of therapy and the status of the patient. Thus we conducted this study to
compare the therapeutic effect of lamivudine-interferon combination therapy versus interferon-alpha
monotherapy in korean patients with chronic hepatitis B.
Method : Among the chronic hepatitis B patients, 138 patients who showed positive to HBeAg,
and serum HBV DNA levels are over 5 pg/mL and serum ALT levels are over 40 IU/L were
allocated to IFN- monotherapy group (70 patients) and lamivudine-interferon combination therapy
group (66 patients). We compared two groups on ALT normalization rate, HBeAg seroconversion
rate, HBV DNA loss rate and HBeAg loss rate in both group. IFN- was percutaneously injected
three times a week. Mean administered dose was 27125 (±11841) MU and mean administered
duration was 6.4 (±1.6) months. Lamivudine was concomitantly and continuously administered with
IFN- for over 6 months (mean 13.2±16.5). The lamivudine therapy was terminated at the point
when HBeAg turned positive into negative.
Results : Mean follow-up period was 28 months. HBeAg loss rate was 40.9% in lamivudineinterferon combination therapy group and 28.6% in IFN- monotherapy group on the 12th month
of the therapy, showing there was no significant difference between the two groups (p=0.13). HBeAg
seroconversion rate was 40.9% in lamivudine-interferon combination therapy group and 21.4% in
IFN- monotherapy group on the 12th month of the therapy (p=0.014). HBV DNA loss rate was
90.9% in lamivudine-interferon combination therapy group and 88.6% in IFN- monotherapy group
within 12months of the therapy, showing there was no significant difference between the two groups
(p=0.35). Serum ALT normalization rate was 92.4% in lamivudine-interferon combination therapy
group and 85.7% in IFN- monotherapy group within 12months of the therapy, showing there was
no significant difference between the two groups (p=0.11).
Conclusion : The lamivudine-interferon combination therapy compared to the Interferon-alpha
monotherapy showed a statistically significant higher HBeAg seroconversion rate.(Korean J Med
65:638-644, 2003)
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KEYWORD
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Hepatitis B, chronic, Interferon-alpha, Lamivudine
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