派罗欣单用和与拉米合用改善组织但无减少纤维化(EASL)

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Peginterferon Alone and in Combination with Lamivudine Improves Liver Histology in Chronic HBV Patients, but Does Not Reduce Fibrosis The two established therapies for chronic hepatitis B (CHB), interferon and lamivudine, have been shown to improve liver histology. Researcher sin the Netherlands studied the effect of pegylated interferon alfa-2b (PEG-IFN) [PEG-Intron] therapy alone and in combination with lamivudine on liver histology. A total of 266 HBeAg-positive CHB patients were treated for 52 weeks with PEG-IFN 100 mg/week in combination with either lamivudine 100 mg/day or placebo in a double-blinded, randomized, multi-center study. PEG-IFN dose was halved after 32 weeks of treatment. Liver biopsies were requested before treatment and at the end of treatment (optional). All biopsies were blinded and scored according to the Ishak system which includes a necroinflammatory score (0-18) and a fibrosis score (0-6). Paired and evaluable biopsies were available for 110 patients. The mean baseline scores of the two treatment groups were comparable. Overall, inflammation score improved (mean score 5.5 pretreatment vs 3.9 posttreatment, p<0.001) and there was a slight progression in fibrosis (mean score 2.4 pretreatment vs 2.7 posttreatment, p=0.03). Necroinflammatory score improved in 25 patients (48%) in the combination group and in 31 patients (53%) in the PEG-IFN monotherapy group. Fibrosis score improved more often in the combination group (17 patients (33%) versus 13 patients (22%) respectively (p=0.23)). In responders (n=48), defined as HBeAg negative at the end of follow-up, inflammation score improved in 65%, compared to 38% of non-responders (n=0.06). In conclusion, the authors state, 揚EG-IFN therapy improves liver histology in CHB patients. The investigators found an improvement in necroinflammatory scores but no significant reduction of fibrosis in both treatment groups.?/span> Erasmus Mc, Rotterdam, The Netherlands. 04/30/04 Reference M van Zonneveld and others. LIVER HISTOLOGY IN CHRONIC HEPATITIS B PATIENTS AFTER 1 YEAR OF TREATMENT WITH PEGYLATED INTERFERON ALPHA-2B IN COMBINATION WITH LAMIVUDINE OR PLACEBO. Abstract 447. 39th EASL. April 14-18, 2004. Berlin, Germany.