RESUMO
<p><b>OBJECTIVE</b>To evaluate the effect of antiviral agents on intrahepatic HBV DNA and histology in HBeAg-positive chronic hepatitis B patients.</p><p><b>METHODS</b>Thirty-five patients were treated with lamivudine, 16 with interferon alfa (INF-alpha), 24 with sequential Lamivudine and INF-alpha. The total duration of therapy was 12 months. Intrahepatic HBV DNA was measured quantitatively by real-time polymerase chain reaction.</p><p><b>RESULTS</b>There was significant change in all parameters of the groups of patients at the end of treatment (P < 0.05). The patients treated with sequential treatment had slightly higher HBeAg seroconversion rate (38.1%) than that of the other patients (P=0.1352). The baseline levels of intrahepatic HBV DNA in the patients with HBeAg seroconversion or undetectable serum HBV DNA were significantly lower than that of the other patients (P < 0.05).</p><p><b>CONCLUSION</b>Antiviral agents could effectively inhibit intrahepatic HBV DNA and improve hepatic histology. The patients with low baseline intrahepatic HBV DNA level may achieve better antiviral efficacy. Sequential treatment might produce high HBeAg seroconversion rate.</p>
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antivirais , Farmacologia , Usos Terapêuticos , DNA Viral , Sangue , Metabolismo , Quimioterapia Combinada , Antígenos E da Hepatite B , Alergia e Imunologia , Metabolismo , Hepatite B Crônica , Tratamento Farmacológico , Alergia e Imunologia , Patologia , Virologia , Interferon-alfa , Farmacologia , Usos Terapêuticos , Lamivudina , Farmacologia , Usos Terapêuticos , Fígado , Metabolismo , Patologia , Virologia , Fatores de TempoRESUMO
<p><b>OBJECTIVE</b>To evaluate the correlation between the efficacy of interferon-alpha-2a and the kinetics of viral load in serum.</p><p><b>METHODS</b>The authors conducted a trial including 58 patients with chronic hepatitis B. Patients were treated with interferon-alpha-2a three times a week for 6 months. Viral kinetics were assessed by serial quantitive measurements of HBV-DNA.</p><p><b>RESULTS</b>A significant decline of serum HBV-DNA was seen after interferon-alpha-2a administration for 1 month, the decreases were (2.50 +/- 0.44) log10, (1.62 +/- 1.12) log10 and (1.05 +/- 1.35) log10 for complete responders, partial responders and no-responders, respectively. After 1 month of treatment, HBV-DNA level was (3.99 +/- 0.91) log10 for complete responders versus (5.63 +/- 1.31) log10 for partial responders, and (6.69 +/- 1.42) log10 for no-responders (P < 0.05). Multivariate analysis suggested that undetectable serum HBV-DNA after 1 month of interferon-alpha-2a treatment was associated with better efficacy; higher baseline ALT or/and no family history were also correlated with better treatment outcomes.</p><p><b>CONCLUSION</b>Kinetics of HBV-DNA level under interferon-alpha-2a treatment are highly predictive of therapeutic response.</p>