Results of an international study in this week's issue of THE LANCET suggest that pegylated interferon alpha offers the best treatment option for people with chronic hepatitis B infection.
Patients successfully treated for chronic hepatitis B are less likely to develop cirrhosis, liver failure, and liver cancer. Previous research has suggested that treatment — either with standard interferon á or nucleoside analogues— is only around 20% effective at best.
Harry Janssen (Erasmus University Medical Centre, Rotterdam, Netherlands) and colleagues assessed whether combination treatment with pegylated interferon á-2â and the antiviral agent lamivudine was more efficacious in treating chronic hepatitis B infection than pegylated interferon á-2â therapy alone. Around 300 patients from 42 centres in 15 countries who had chronic hepatitis B were assigned combination therapy or monotherapy for one year.
36% of patients assigned monotherapy and 35% assigned combination therapy had a sustained viral response (clearance of the hepatitis B e Ag) indicating disease remission at the end of the half year follow-up period.
The study also highlights the importance of hepatitis B virus genotype as a predictor of response to pegylated interferon á-2â treatment. Dr Janssen comments: "Just like in chronic hepatitis C, the genotype of the hepatitis B virus will tell us what the likelihood of response is. It will become our best tool towards individualized treatment for patients with chronic hepatitis B".
Dr Janssen concludes: "Pegylated interferon á-2â is effective and well tolerated for chronic hepatitis B. Rates of sustained viral clearance and reduction of viral load are as high as or higher than those that have previously been reported for any other therapy."
Contact: Dr Harry L A Janssen, Room Ca 326, Department of Gastroenterology and Hepatology, Erasmus University Medical Centre Rotterdam, Dr. Molewaterplein 40, 3018 GD, Rotterdam, Netherlands;
Tel: 31-10-463-3793 or 31-65-335-0652;
Fax: 31-10-436-5916 h.janssen@erasmusmc.nl
Journal
The Lancet