Background/Aims: Lamivudine is effective in treatment-naive patients with chronic hepatitis B, but its role in interferon nonresponders has not been described. We assessed lamivudine treatment, with or without added interferon, in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B who had failed interferon therapy previously. Methods: Patients were randomized to lamivudine (100 mg) or placebo for 52 weeks or to a 24-week regimen of lamivudine plus interferon. Primary treatment comparisons were at week 52, with a 16-week posttreatment follow-up period. Measurements included histology (primary endpoint), HBeAg response, normalization of alanine aminotransferase, reduction of hepatitis B virus (HBV) DNA, and safety. Results: Among 238 patients, histologic response was significantly more common in patients treated with lamivudine (52 versus placebo 25%, P = 0.002) or the combination regimen (32%, P = 0.01). HBeAg loss was also more common with lamivudine (33 versus 13 versus 21%), as were virologic and alanine aminotransferase responses. Among 28 subjects with HBeAg loss/seroconversion, 71% had durable responses 16 weeks posttreatment. Conclusions: Lamivudine for 52 weeks is as effective in interferon nonresponders as in previously reported treatment-naive patients; however, a combination of lamivudine for 24 weeks and interferon for 16 weeks was not effective in this population.

Chronic hepatitis, Hepatitis B, Hepatitis B e antigen, Interferon, Interferon nonresponder, Lamivudine
dx.doi.org/10.1016/S0168-8278(03)00076-X, hdl.handle.net/1765/66262
Journal of Hepatology
Department of Gastroenterology & Hepatology

Schiff, E, Dienstag, J.L, Karayalcin, S, Grimm, I.S, Perrillo, R.P, Husa, P, … Brown, N.A. (2003). Lamivudine and 24 weeks of lamivudine/interferon combination therapy for hepatitis B e antigen-positive chronic hepatitis B in interferon nonresponders. In Journal of Hepatology (Vol. 38, pp. 818–826). doi:10.1016/S0168-8278(03)00076-X