| Autor: |
Christian Jacquelinet, Véronique David, Dominique Guyader, Martine Blayau, Monique Guéguen, M. Messner, Pierre Brissot, Gérard Lescoat, Yves Deugnier, H. Jouanolle |
| Rok vydání: |
1991 |
| Předmět: |
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| Zdroj: |
Journal of Hepatology. 12:181-189 |
| ISSN: |
0168-8278 |
| DOI: |
10.1016/0168-8278(91)90936-6 |
| Popis: |
Twenty-nine patients with chronic hepatitis B, presenting both hepatitis B surface antigen and hepatitis B virus deoxyribonucleic acid in serum, were studied in a randomized trial treatment consisting of oral prednisolone for 28 days followed 14 days after steroid withdrawal, by either a 55 s.c. injection course of 5 M unit recombinant human α-interferon (group 1, 14 patients) or by adenine-arabinoside (for 21 days) combined from the forteenth day on with the same 55 s.c. injection schedule of interferon (IFN) (group 2, 15 cases). The two groups were well matched with respect to demographic, biochemical, virological and histologic features. Significant side-effects leading to premature discontinuation of interferon were observed in only four cases in group 2 and were always reversible. Efficacy was judged on a mean follow-up period of 17 months. For the whole population, 17 patients (59%) exhibited a sustained serum hepatitis B virus deoxyribonucleic acid disappearance which corresponded to a marked improvement in liver function as demonstrated by a quasi-normalization of their serum transaminase values (ALT with n P p = 0.042; Fisher's exact test) and a higher HBe seroconversion rate (814 = 57% vs. 413=31% in group 1; p=0.17; chi-square) reaching 60% (vs. 36% in group 1) when taking into account two patients (one in each group) with initially HBeAg(−) Anti-HBe(+) HBV-DNA (+) chronic active hepatitis who developed a sustained HBV-DNA loss with ALT normalization. These findings confirm the interest of associating corticosteroid pretreatment and antiviral therapy in chronic hepatitis B and suggest that this therapeutic approach could be improved by combining two antiviral agents. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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