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Pegylated interferon alpha-2a (40 kDa) in the treatment of chronic hepatitis B

Authors Lawrence Lai, Chee-Kin Hui, Nancy Leung, George K Lau

Published 15 September 2006 Volume 2006:1(3) Pages 255—262

Lawrence Lai1, Chee-Kin Hui2,3,4, Nancy Leung5, George K Lau2,3,4

1Department of Medicine, Caritas Medical Centre, Hong Kong SAR, China; 2Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China; 3Centre for the Study of Liver Disease, The University of Hong Kong, Hong Kong SAR, China; 4Research Centre for Infection and Immunity, The University of Hong Kong, Hong Kong SAR, China; 5Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, China

Abstract: Chronic hepatitis B virus (HBV) is a serious and life-threatening disease afflicting 350 million of the world’s population. So far, current monotherapy with conventional interferon-alpha, lamivudine, and adefovir dipivoxil remains unsatisfactory. In addition, the use of conventional interferon-alpha needs to be administered subcutaneously daily or thrice weekly and is associated with frequent adverse events. Although nucleoside–nucleotide analogs such as lamivudine and adefovir dipivoxil are well tolerated and can normalize serum alanine aminotransaminase rapidly, 1-year therapy with either lamivudine or adefovir dipivoxil results in low hepatitis B e antigen (HBeAg) seroconversion rates. In HBeAg negative patients, most of the patients would relapse after lamivudine has been discontinued. Pegylated interferon alpha-2a, an immunomodulatory agent, is a new drug that has just completed phase III clinical trials for the treatment of both HBeAg positive and HBeAg negative chronic HBV infection. The advantage of pegylated interferon alpha-2a in achieving sustained virological response over nucleoside–nucleotide analogs is particularly obvious in the HBeAg negative group. In both of these phase III studies, sustained off-treatment response is superior to the use of lamivudine. These recent data put pegylated interferon alpha-2a as the first choice of anti-HBV therapy, especially in young and motivated patients with chronic HBV infection.

Keywords: pegylated interferon alpha-2a, chronic hepatitis B, HBeAg seroconversion, sustained virological response

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