Pegylated Interferon Alfa-2b (PegIntron) and Adefovir Dipivoxil (Hepsera) Combination Therapy Leads to a Strong Suppression of cccDNA and High Rates of HBe and HBs Seroconversion
HBV targeted antiviral therapy with adefovir dipivoxil/ ADV (Hepsera) results in a significant reduction of intrahepatic HBV DNA and cccDNA, serum HBsAg, and serum HBV DNA (Werle-Lapostolle, Gastroenterology 2004). Pegylated interferon alfa (Peg IFN) improves serological outcome in HBeAg positive and HBeAg negative patients (Lau, AASLD 2004; Marcellin, New Engl J Med 2004).
The aim of this study was to determine the virological and serological outcome in patients with chronic hepatitis B treated with Peg IFN alfa-2b (PegIntron) and ADV.
26 patients with chronic hepatitis B were included in a single center open label pilot study.
Patients received a 48 week course of antiviral combination therapy with 12kDa pegylated interferon alfa 2b 1.5礸/kg sq qw and ADV 10mg qd. Intrahepatocellular cccDNA, serum HBsAg, and serum HBV DNA was quantified as described previously (Werle-Lapostolle, Gastroenterology 2004).
Baseline characteristics:
Median age, years:牋牋 牋牋牋牋牋牋牋?33
Male:牋牋牋牋牋牋牋牋牋牋? 牋牋牋牋牋牋牋?牋?4
Caucasian:牋牋牋牋牋 牋牋牋牋牋牋牋?牋牋牋21
Asian:牋牋牋牋牋牋牋牋牋牋 牋牋牋牋牋牋牋牋牋牋 5牋牋牋牋牋牋?br> HBeAg +:牋牋牋牋牋牋牋 牋牋牋牋牋牋牋?牋牋15
HBeAg ?牋牋牋牋牋牋牋 牋牋牋牋牋牋牋?牋牋 11
HBV DNA, PCR: ?牋牋牋牋牋牋牋? x 106
(log10 copies/ml, median)
ALT (xULN, median):牋牋牋牋牋牋牋??3,1
Results at week 48, compared to week 0:
cccDNA reduction (median) from paired biopsies: ????牋-2.2log
Serum HBsAg titer reduction (median):牋牋牋牋牋牋牋牋牋牋牋牋牋 - 44%
Serum HBV DNA reduction (median):牋牋牋牋牋牋?牋牋牋牋牋牋 -4.7log?br> Serum HBV DNA <100 copies/ml:牋 牋牋牋牋牋牋牋?牋牋?12/23(52%)
(LLoD, LightCycler, Roche)牋牋牋牋牋牋牋牋牋
HBeAg loss:牋牋牋牋 牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋?牋牋牋牋牋牋牋?7/13 (54%)
HBeAg seroconversion:牋 ?牋牋牋牋牋牋牋?牋牋牋牋牋牋牋牋牋牋5/13 (38%)
HBsAg seroconversion:牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋 4/23 (17%)
ALT normalisation:牋牋? 牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋??牋牋?10/23 (43%)
ALT improvement:牋牋牋 牋牋牋牋牋牋牋牋牋牋牋牋牋牋牋?牋?牋?19/23 (83%)
METAVIR histology score improved:牋牋牋牋牋牋?牋牋牋 13/21 (62%)
Conclusions
The authors conclude, 揂dministration of 48 weeks of Peg IFN alfa-2b and adefovir dipivoxil resulted in a strong suppression of cccDNA, high rates of HBsAg seroconversion, HBeAg seroconversion and loss, respectively.
揅ombination therapy was safe and well tolerated. No unexpected adverse events were reported. All patients are continuing in study on additional 96 weeks of ADV monotherapy followed by a third liver biopsy.?/span>
05/16/05
Reference
J Petersen and others. Combination Therapy of Pegylated Interferon Alfa 2b and Adefovir Dipivoxil in Chronic Hepatitis B (CHB) Patients Leads To a Strong Suppression of CccDNA and High Rates 0f HBe and HBs Seroconversion. Abstract M933. Digestive Disease Week 2005. May 14-19, 2005. Chicago, IL.
|