Successful Treatment with Peginterferon alfa-2b of HBeAg-positive HBV Non-Responders to Standard Interferon or Lamivudine

Flink, Hajo J.; Hansen, Bettina E.; Heathcote, E. Jenny; Feinman, S.V.; Şimşek, Halis; Karayalçın, Selim; Mach, Tomasz; Leemans, W F; Man, Robert A. de; Verhey, Elke; Schalm, Solko W.; Janssen, Harry L.A.

doi:10.1111/j.1572-0241.2006.00812.x

Cited by 29 publications

(25 citation statements)

References 15 publications

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“…After 1-year therapy, clearance of HBeAg occurred in 30-36% of patients treated with peginterferon compared to 4-12% of placebo recipients, and the serum HBV DNA levels became undetectable by PCR-based assays in 25% of treated patients [31][32][33][34][35]. Furthermore, peginterferon is effective in approximately one-third of patients who failed to respond to previous standard IFN treatment [36]. Even in patients with advanced fibrosis, peginterferon has been reported to be effective and safe [37].…”

Section: Discussionmentioning

confidence: 92%

Meta-analysis: the effect of interferon on development of hepatocellular carcinoma in patients with chronic hepatitis B virus infection

2009

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Section: Discussionmentioning

confidence: 92%

Meta-analysis: the effect of interferon on development of hepatocellular carcinoma in patients with chronic hepatitis B virus infection

2009

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“…Patients with elevated serum ALT at the time of starting Peg IFN treatment had a better response rate [55]. A study of Peg IFN-a-2a in non-responders to lamivudine or adefovir dipivoxil presented at the APASL meeting in Manila, in 2006, also found that the response rates were similar to response rates seen in naïve chronic hepatitis B patients [56].…”

Section: Combination Therapymentioning

confidence: 87%

“…The treatment with a 52-week course of Peg IFN-a-2b of HBeAg-positive non-responders to lamivudine showed HBeAg seroconversion in 29% and ALT normalization in 41% at 26 weeks after the end of treatment [55]. Patients with elevated serum ALT at the time of starting Peg IFN treatment had a better response rate [55].…”

Section: Combination Therapymentioning

confidence: 99%

Reviews for APASL guidelines: immunomodulator therapy of chronic hepatitis B

Piratvisuth

2008

Hepatol Int

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The primary aim of immunomodulator therapy is to help the natural human immune system to mount a defense against hepatitis B virus. IFN-a has been used for the treatment of HBeAg-positive and HBeAg-negative chronic hepatitis B for over two decades and has been shown to be effective in suppressing HBV replication and in inducing serological response leading to long-term clinical benefits. IFN-a has been used in patients with wellcompensated cirrhosis with comparable or better response to that in non-cirrhotic patients. IFN-a therapy in patients with cirrhosis has a similar side effect profile as in those without cirrhosis. However, IFN-a is contraindicated in patients with overt or decompensated cirrhosis. Pegylated IFN-a has been shown to be effective in treatment of chronic hepatitis B with sustained response rate in about one-third of the treated patients. Peg IFN-a treatment in non-responders to lamivudine or adefovir dipivoxil showed similar response rate to that seen in naïve patients. Thymosin a 1 is effective in treatment of HBeAg-positive and HBeAg-negative chronic hepatitis B with a significantly increasing virological response over time after therapy.

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“…wk of follow-up, Lamivudine study performed in children, 15 Includes some lamivudine resistant patients. Teuber; Z Gastroenterol; 1995 [161] Positive (27) 30 59 Flink; Hepatology; 2004 [162] PEG-IFN-α 2b 100 μg/wk for 32 wk followed by 50 μg/wk for 20 wk www.wjgnet.com efficacy may be different and data are limited [36] . A clinical trial using adefovir dipivoxil included 123 HBeAg positive and 48 HBeAg negative patients failing prior interferon therapy.…”

Section: Retreatment Of Non-respondersmentioning

confidence: 99%

Future prospectives for the management of chronic hepatitis B

Leemans

Janssen

Man³

2007

WJG

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Chronic hepatitis B virus infection affects about 400 million people around the globe and causes approximately one million deaths a year. Since the discovery of interferon-α as a therapeutic option the treatment of hepatitis B has evolved fast and management has become increasingly complicated. T h e a m o u n t o f v ira l re p l ic a t io n re f le c t e d in t he viral load (HBV-DNA) plays an important role in the development of cirrhosis and hepatocellular carcinoma. The current treatment modalities for chronic hepatitis B are immunomodulatory (interferons) and antiviral suppressants (nucleoside and nucleotide analogues) all with their own advantages and limitations. An overview of the treatment efficacy for both immunomodulatory as antiviral compounds is provided in order to provide the clinician insight into the factors influencing treatment outcome. With nucleoside or nucleotide analogues suppression of viral replication by 5-7 log10 is feasible, but not all patients respond to therapy. Known factors influencing treatment outcome are viral load, ALT levels and compliance. Many other factors which might influence treatment are scarcely investigated. Identifying the factors associated with response might result in stopping rules, so treatment could be adapted in an early stage to provide adequate treatment and avoid the development of resistance. The efficacy of compounds for the treatment of mutant virus and the crossresistance is largely unknown. However, genotypic and phenotypic testing as well as small clinical trials provided some data on efficacy in this population. Discontinuation of nucleoside or nucleotide analogues frequently results in viral relapse; however, some patients have a sustained response. Data on the risk factors for relapse are necessary in order to determine when treatment can be discontinued safely. In conclusion: chronic hepatitis B has become a treatable disease; however, much research is needed to tailor therapy to an individual patient, to predict the sustainability of response and determine the best treatment for those failing treatment.

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Successful Treatment with Peginterferon alfa-2b of HBeAg-positive HBV Non-Responders to Standard Interferon or Lamivudine

Abstract: Peg-IFN alpha2b is effective in approximately one-third of patients who failed to respond to previous treatment with standard IFN or lamivudine. High serum ALT level at baseline of Peg-IFN alpha2b therapy was the best predictor for response in these patients.

Cited by 29 publications

References 15 publications

Meta-analysis: the effect of interferon on development of hepatocellular carcinoma in patients with chronic hepatitis B virus infection

Meta-analysis: the effect of interferon on development of hepatocellular carcinoma in patients with chronic hepatitis B virus infection

Reviews for APASL guidelines: immunomodulator therapy of chronic hepatitis B

Future prospectives for the management of chronic hepatitis B

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