Efficacy of alpha interferon therapy for lamivudine resistance in chronic hepatitis B

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Abstract
Objectives: The occurrence of lamivudine resistance is often associated with the clinical breakthrough, which is characterised by the reappearance of hepatitis B virus (HBV) DNA in serum and the elevation of aminotransferases. We evaluated the efficacy of alpha interferon for clinical breakthrough in patients receiving lamivudine therapy. Patients: Six chronic hepatitis B patients receiving lamivudine were enrolled in the study. Results: Under lamivudine therapy, clinical breakthroughs occurred in between fifteenth and thirty‐fourth month of lamivudine therapy. HBV DNA reappeared, and alanine aminotransferase was elevated. Genotypic analysis showed M552V, M552I and L528M mutations. After determining the clinical breakthrough, standard alpha interferon‐2b was given for 6 months. Lamivudine was also maintained. In only one patient, HBV DNA became negative by polymerase chain reaction, and serum alanine transaminase level was normal at the end of therapy. Conclusion: Alpha interferon added to lamivudine is generally ineffective in the treatment of lamivudine resistance.