The Effectiveness of Nucleoside Analogues in Chronic Hepatitis B Patients Unresponsive to Interferon Therapy: Our Clinical Trials for One Year

authors:

avatar Sukran Kose 1 , * , avatar Melda Turken 2 , avatar Gulsun Cavdar 2 , avatar Gulgun Akkoclu 2

Tepecik Research and Training Hospital, Clinic of Clinical Microbiology and Infectious Diseases, Tepecik, sukrankose@yahoo.com, Turkey
Tepecik Research and Training Hospital, Clinic of Clinical Microbiology and Infectious Diseases, Tepecik, Turkey

How To Cite Kose S, Turken M, Cavdar G, Akkoclu G. The Effectiveness of Nucleoside Analogues in Chronic Hepatitis B Patients Unresponsive to Interferon Therapy: Our Clinical Trials for One Year. Hepat Mon. 2010;10(4): 289-293. 

Abstract

Background and Aims: We aimed to evaluate the effectiveness of nucleoside analogues such as Lamivudine, Adefovir, Entacavir, and Tenofovir in patients with chronic hepatitis B who failed to respond to interferon therapy and relapsed.
Materials and Methods: We followed a total of 73 patients with hepatitis B in the hepatitis outpatient clinic in our hospital. The patients subsequently received nucleoside analogues therapy and their treatment data were evaluated retrospectively. The biochemical and virological response rates were evaluated at 3 and 12 months, and we compared these results with the results of treatment-naive patients.
Results: There were 29 (39.7%) HbeAg-positive and 44 (60.3%) HbeAg-negative patients, and their mean age was 35.8 (±13.4) years. Of these patients, 33, 18, 13 and 9 received Entacavir, Tenofovir, Lamivudine, and Adefovir treatment, respectively. In HbeAg-negative patients, at 3 months the biochemical and virological response (early response) rates were observed to be 91% and 98%), and at 12 months the two rates were 93% and 73%, respectively. In HbeAg-positive patients, the biochemical and virological response rates at 3 months were 83% and 97%, and the rates at 12 months were 90% and 48%, respectively.
Conclusions: In CHB therapy with treatment-resistent patients, nucleoside analogues may be preferable. There are disadvantages to nucleoside analogues, such as a risk of developing resistance during therapy, reduced HBeAg seroconversion compared to interferons, and the therapy's ambiguous duration. In our study, in HbeAg-negative patients who received nucleoside analogues, a lower biochemical response rate was detected in patients with 1 year of Lamivudine therapy compared to other therapies.  For HbeAg-positive patients, the virological response rate was higher in 1 year of Tenofovir therapy than with other therapies.

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