Chronic Hepatitis B: Interferon Alone or with Lamivudine?

Therapeutic options for chronic hepatitis B include interferon alfa and DNA polymerase inhibitors such as lamivudine or adefovir dipivoxil. Lamivudine can achieve profound reductions in viral load, but these responses rarely are durable, and drug resistance frequently emerges; long-term outcomes with adefovir remain unknown. In contrast, treatment with interferon has been reported to clear HBeAg and HBV DNA in as many as one third of patients, and 80% to 90% of these patients have had durable responses. In a recent study (Journal Watch Oct 12 2004), peginterferon produced durable clearance of HBV DNA in 19% of patients with chronic HBeAg-negative hepatitis B, but adding lamivudine provided little benefit. Now, a multinational team of resear…