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

Second Military Medical University, Shanghai, Shanghai, Shanghai Shi, China
Clinical Infectious Diseases (Impact Factor: 9.42). 03/2007; 44(4):541-8. DOI: 10.1086/511042
Source: PubMed

ABSTRACT 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.
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.
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.
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.

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