Genotype B and younger patient age associated with better response to low-dose

2002落叶

Genotype B and younger patient age associated with better response to
low-dose therapy: a trial with pegylated/nonpegylated interferon-alpha-2b
for hepatitis B e antigen-positive patients with chronic hepatitis B in
China.

Zhao H, Kurbanov F, Wan MB, Yin YK, Niu JQ, Hou JL, Wei L, Wang GQ, Tanaka
Y, Mizokami M, Si CW.

Peking University First Hospital, Beijing 100034, China.

BACKGROUND: Cost and clinically significant adverse effects are the major
limiting factors of interferon (IFN) use in therapy for chronic hepatitis B
virus (HBV) infection. A clinical trial was conducted in China to study the
efficiency and clinical relevance of low-dose regimen of IFN treatment for
chronic HBV infection and to reveal factors predicting sustained combined
response. METHODS: During a randomized, open-label control study, hepatitis
B e antigen (HBeAg)-positive patients with chronic HBV infection (n=230)
were assigned to receive pegylated IFN- alpha -2b (1.0 micro g/kg) (n=115)
or IFN- alpha -2b (3 MIU; n=115) for a 24-week period. Sustained combined
response was assessed 24 weeks after the completion of treatment. RESULTS:
The greater rate of HBeAg loss in the pegylated IFN-group (23%) was the only
statistically significant difference between the 2 treatment arms observed
at the end of follow-up. The results of the multivariate statistical
analysis revealed that HBV genotype B and patient age (< or =25 years) were
2 independent factors associated with sustained combined response. A total
of 40% of patients with HBV genotype B aged < or =25-years achieved
sustained combined response. Only 4 (1.7%) of 230 patients discontinued
therapy because of clinically significant adverse effects. CONCLUSIONS: The
choice of low-dose IFN regimen might be a relevant clinical option to reduce
the cost and adverse effects of therapy for younger patients with chronic
HBV infection and genotype B infection in countries where it is prevalent.

PMID: 17243057 [PubMed - in process]