FAILURE OF ACYCLOVIR TO ENHANCE THE ANTIVIRAL EFFECT OF ALPHA-LYMPHOBLASTOID INTERFERON ON HBE-SEROCONVERSION IN CHRONIC HEPATITIS-B - A MULTICENTER RANDOMIZED CONTROLLED TRIAL

被引:40
作者
BERK, L
SCHALM, SW
DEMAN, RA
HEYTINK, RA
BERTHELOT, P
BRECHOT, C
BOBOC, B
DEGOS, F
MARCELLIN, P
BENHAMOU, JP
HESS, G
ROSSOL, S
ZUMBUSCHENFELDE, KHM
CHAMULEAU, RAFM
JANSEN, PLM
REESINK, HW
MEYER, B
BEGLINGER, C
STALDER, GA
DENOUDENMULLER, JW
DEJONG, M
机构
[1] ERASME UNIV HOSP,DEPT INTERNAL MED 2,B-1070 BRUSSELS,BELGIUM
[2] ERASMUS UNIV,DEPT VIROL,3000 DR ROTTERDAM,NETHERLANDS
[3] HOP LAENNEC,DEPT HEPATOL,F-75340 PARIS 07,FRANCE
[4] HOP BEAUJON,DEPT HEPATOL,F-92118 CLICHY,FRANCE
[5] ST FRANCIS HOSP,DEPT INTERNAL MED,ROTTERDAM,NETHERLANDS
[6] UNIV MAINZ,MED 1 KLIN & POLIKLIN,W-6500 MAINZ,GERMANY
[7] UNIV AMSTERDAM,ACAD MED CTR,DEPT HEPATOGASTROENTEROL,1105 AZ AMSTERDAM,NETHERLANDS
[8] KANTONSSPITAL,DEPT INNERE MED,CH-4004 BASEL,SWITZERLAND
关键词
D O I
10.1016/0168-8278(92)90175-O
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Serum HBeAg levels and HBe-seroconversion were investigated in patients with chronic HBeAg-positive hepatitis who were randomized to receive either alpha-lymphoblastoid interferon (5 megaunits subcutaneously daily for 16 weeks) plus acyclovir (2 g intravenously daily during weeks 1 and 2 and weeks 9 and 10) (n = 49) or no treatment (n = 48). HBeAg levels in serial dilutions of patient serum were assessed quantitatively by radioimmunoassay and compared with the values found for negative control serum. One year after the start of therapy 44 treated patients and 43 control patients were available for follow-up. A complete response (HBe-seroconversion) occurred in 11 treated patients (25%) and six controls (14%) (difference: 11%, 95% CI-5-28%). A partial response (HBeAg < 50% of initial level) was found significantly more often for treated patients (n = 13, 30%) than for controls (n = 2, 5%) (difference: 25%, 95% CI 10-40%). During acyclovir-interferon combination therapy the decrease in HBeAg level was similar to that achieved during therapy with interferon alone. We conclude that acyclovir does not enhance the effect of interferon on serum HBeAg levels. Since HBeAg levels continue to decline during interferon treatment and rebound thereafter to pretreatment levels, prolongation of therapy may yield a higher response rate.
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页码:305 / 309
页数:5
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