Efficacy of alpha interferon therapy for lamivudine resistance in chronic hepatitis B

Abstract

Alpha interferon added to lamivudine is generally ineffective in the treatment of lamivudine resistance.

The effect of pegylated interferon-α on the treatment of lamivudine resistant chronic HBeAg positive hepatitis B virus infection

“…This response is lower than that observed in other trials of pegylated interferon-a treatment for HBeAgpositive patients, where the percentage of e-loss was over 30% [14,18]. However, the response rate was in line with that observed in the earlier trials with lamivudine-resistant patients, where between 16 and 22% of patients responded to pegylated interferon-a [2][3][4][5]. If we limit the analysis to the patients receiving monotherapy PEG-interferon-a none of the 12 (0%) responded to therapy.…”

“…Previous studies with this patient group used non-pegylated interferon-a and were limited in the number of patients studied [2][3][4], the length of treatment (6 months) and treatment schedules. The small number of responders to treatment prevented us from drawing definitive conclusions about the benefits of interferon therapy in this group.…”

“…Chronic hepatitis B is an immunological-based liver disorder, and there is increasing evidence that only a complete and vigorous HBV-specific immune response can achieve control and elimination of the virus, preventing disease progression [1]. The subgroup of HBeAg-positive hepatitis B patients with proven lamivudine resistance are little studied, and existing studies are often hampered by their extent and design [2][3][4][5], which makes it difficult to draw definitive conclusions about the optimal treatment for this group. In the study reported here, which is the largest cohort study to date, we investigate the response of HBeAg-positive hepatitis B patients with proven lamivudine resistance to pegylated interferon-a.…”

Randomised clinical trial: efficacy of peginterferon alfa-2a in HBeAg positive chronic hepatitis B patients with lamivudine resistance

“…In contrast with the need for extended treatment with NAs to ensure constant viral suppression, a finite course of interferon‐based therapy is not associated with resistance development and can induce a sustained immunological response, as illustrated by hepatitis B e antigen (HBeAg) seroconversion and hepatitis B surface antigen (HBsAg) seroconversion, in a proportion of patients. Initial data suggested that it may provide a novel therapeutic option for management of patients carrying lamivudine resistant virus 12–16 . However, because of the limitation of study design and small sample size, it is difficult to make definitive conclusion.…”

Sensitivity of drug-resistant mutants of hepatitis B virus to poly-IC

“…IFN-α-based therapy is typically administered for a definite period of time and can induce a sustained suppression of viral replication after the treatment suspension. A few studies have shown that in patients with YMDD-mutated virus after previous lamivudine treatment, the response to IFN-α treatment in combination with lamivudine was mixed (Suzuki et al, 2002;Danalioglu et al, 2004). Therefore, understanding the effects of IFN-α on the inhibition of drug-resistant HBV mutants in vivo is important and could provide some suggestions on the management of HBV drug resistance in clinical treatment.…”