Efficacy of sequential therapy with interferon-alpha and lamivudine combination in hepatitis B patients

Objective To observe the responses of chronic hepatitis B patients treated by interferon and lamivudine sequentially and to explore the effective method for the treatment of chronic hepatitis B.Methods 107 patients were randomly divided into 3 groups.The patients in group A (sequential lamivudine and interferon group) first received lamivudine,then intramuscular injection of interferon.The patients in group B (lamivudine group) were administrated with lamivudine alone.The patients in group C (interferon group) were injected with interferon alone.The rates of ALT returning to normal,HBeAgloss,HBeAg/antiHBe seroconversion,undetectable HBV-DNA and YMDD mutation at the end of treatment,6 months after treatment and 12 months after treatment were calculated.Results After treatment for 6 months,12 months,rate of ALT retuning to normal in group A were 85.3％ and 82.4％,respectively.Both were higher than those in group B (59.5％ and 47.6％,P ＜ 0.05).The rate of HBeAg loss at the end of the treatment,6 months and 12 months after treatment in group A were 58.8％,55.9％ and 55.9％,respectively and were higher than that of group B (28.6％,21.4％,and 16.7％,P ＜0.01)and group C (32.3％,29.0％,and 29.0％,P ＜ 0.05).At the end of the treatment,the rate of undetectable HBV-DNA in group A was 88.2％ and was higher than group C (38.7％,P ＜0.01).At 6 months and 12 months after treatment,the rate of undetectable HBV-DNA in group A were 82.4％ and 73.5％,respectively,and were significantly higher than that of group B (47.6％ and 38.1％) and group C (35.5％ and 32.3％,P ＜0.01).At the end of the treatment HBeAg/Ab-HBe seroconversion rate in group A was 52.9％,higher than 16.7％ in group B and 29.0％ in group C(P ＜0.05).After treatment,the YMDD mutation rate in group A was 8.8％,which was lower than 28.6％ in group B (P ＜ 0.05).Conclusions Sequential therapy with lamivudine and interferon is superior to lamivudine or interferon alone in synergistic effect.The therapy will not only improve the recent curative effect and reduce the bounce,but also reduce the virus mutation rates and long-term recurrence rate. Key words: Lamivudine;  Interferon;  Chronic hepatitis B