Background an aims: 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. Patients and methods: HBV ge...Background an aims: 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. Patients and methods: HBV genotypewas determined by direct sequencing of the HBV Xgene in 165 consecutive patientswith 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 pretreatment alanine aminotransferase levels (> 2x upper limit of normal) as independent positive predictive parameters of IFN response. Conclusions: 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.展开更多
文摘Background an aims: 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. Patients and methods: HBV genotypewas determined by direct sequencing of the HBV Xgene in 165 consecutive patientswith 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 pretreatment alanine aminotransferase levels (> 2x upper limit of normal) as independent positive predictive parameters of IFN response. Conclusions: 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.
