The comparison of the efficacy of pegylated interferon α-2a and α-2b in chronic hepatitis B patients.

BACKGROUND/AIM: Although 48-week therapy with pegylated-interferons has been shown to be effective for the treatment of chronic hepatitis B (CHB), comparison of the efficacy of pegylated-interferon α-2a (Peg-IFNα-2a) and Peg-IFNα-2b in the therapy is not obvious. We aimed to compare the efficacy of Peg-IFNα-2a versus Peg-IFNα-2b in the treatment of CHB. PATIENTS AND METHODS: Fifty-one CHB patients treated with 48 weeks of Peg-IFNα-2a (n=24) and Peg-IFNα-2b (n=27) who had been followed up between 2009 and 2011 at the Liver Clinic of Adana Numune Training and Research Hospital, Turkey, were investigated retrospectively. Six (25%) patients in the Peg-IFNα-2a group and nine (33%) in the Peg-IFNα-2b group were HBeAg-positive. Serum HBV-DNA, HBeAg, and HBsAg values were assessed at baseline. Biochemical and virological responses were evaluated every 12 weeks during the course of the treatment, at the end of the treatment, and follow-up week 24. Sustained virological response (SVR) was defined as sustained inhibition of viral replication (HBV-DNA<10 000 copies/ml) and a normal alanine aminotransaminase level until 24 weeks after treatment. Undetectable HBV-DNA was considered as less than 400 copies/ml. RESULTS: Six of the 24 (25%) patients treated with Peg-IFNα-2a versus eight of the 27 (29.6%) patients treated with Peg-IFNα-2b achieved an SVR (P=0.75). HBeAg seroconversion occurred in three patients only in the Peg-IFNα-2b group. Rates of patients with undetectable HBV-DNA at 24 weeks after a 48-week course of therapy were 20.8% for Peg-IFNα-2a and 22.2% for Peg-IFNα-2b (P=0.82). CONCLUSION: In CHB, there were no significant differences between Peg-IFNα-2a and Peg-IFNα-2b treatment groups in achieving an SVR and undetectable HBV-DNA levels.

Relationship of CA 19-9 with choledocholithiasis and cholangitis.

BACKGROUND/AIMS: It is well known that increased concentrations of CA 19-9 can be found in benign disease of the liver, pancreas and biliary tract, especially in cases with gallstone disease with cholangitis. The aim of this study was to investigate the relation of CA 19-9 with the number and size of the stones, cholangitis and biliary obstruction in patients with choledocholithiasis. METHODS: Seventy patients with radiologically proven choledocholithiasis were studied. Endoscopic retrograde cholangiopancreatography, sphincterotomy and stone extraction were applied to all patients. In each case, the parameters recorded included the levels of CA 19-9 and other laboratory tests before and after endoscopic retrograde cholangiopancreatography and the results of imaging techniques and immunoserologic tests. The correlations of these parameters were determined by SPSS 17 package program for statistical analysis. RESULTS: Elevation of CA 19-9 was found in 32 patients (46%), while 8 patients (11%) had extraordinarily high levels (>1000 U/ml). CA 19-9 levels were correlated with serum alkaline phosphatase (r=0.5, p<0.01), gamma glutamyl transpeptidase (r=0.5, p<0.01) and bilirubin (r=0.4, p<0.01) levels but not with aspartate aminotransferase or alanine aminotransferase levels. There was also no association between serum CA 19-9 levels and the number and size of stones. Six patients had cholangitis. CA 19-9 levels were found higher in patients with cholangitis than others (100% vs. 41%, p<0.01) as well as alkaline phosphatase, gamma glutamyl transpeptidase and bilirubin levels. After stone extraction, CA 19-9 levels started to decrease and reached normal values 1-28 days later. CONCLUSION: In conclusion, CA 19-9 levels are associated with biliary obstruction and cholangitis but not with the number and size of stones in patients with choledocholithiasis.