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Response
to Interferon Alfa Is Dependent on the Hepatitis B Virus: Genotype
A is More Sensitive to Interferon Than Genotype D
Current interferon
alfa (IFN) treatment of chronic
hepatitis B has limited efficacy.
The role of hepatitis B virus (HBV)
genotypes
for response to IFN was investigated. Genotype was determined by
direct sequencing of the HBV X gene in 165 consecutive patients
with chronic replicative hepatitis B treated with standard IFN.
HBV
genotype A or D was found in 144 cases.
Results
·
Sustained
response (six months after treatment)
to standard IFN therapy was higher in HBV
genotype A compared with HBV
genotype D
infected patients (49% v 26%; p<0.005).
· Sustained
response to IFN was 46% versus 24% (p<0.03) in hepatitis
B e antigen (HBeAg) positive hepatitis (n = 99) and 59% versus
29% (p<0.05) in HBeAg negative hepatitis
(n = 45) for HBV genotype A compared with HBV genotype D.
· HBeAg
status had no negative impact on IFN response.
· Multivariate
logistic regression identified HBV genotype A and high pre-treatment
alanine aminotransferase levels (>2xupper limit of
normal) as independent positive predictive parameters of IFN response.
According
to the authors, the present study indicates that HBV genotypes A
and D are important and independent predictors of IFN responsiveness
in chronic hepatitis B. HBV genotype adapted treatment regimens
may further improve treatment efficacy in chronic hepatitis B.”
Klinik fur Gastroenterologie,
Hepatologie und Infektiologie, Heinrich-Heine-Universitat Dusseldorf,
Dusseldorf, Germany.
06/20/05
Reference
A
Erhardt and others. Response to interferon alfa is hepatitis
B virus genotype dependent: genotype A is more sensitive to interferon
than genotype D. Gut 54(7):1009-1013. July 2004.
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