Treatment of chronic hepatitis Be antigen-positive hepatitis B with lamivudine combined alpha interferon

Objective:To evaluate the curative effect of lamivudine combined with alpha interferon for treating chronic hepatitis Be antigen-positive hepatitis B and its influence factors.Methods:64patients with chronic hepatitis Be antigen-positive hepatitis B were enrolled and ranˉdomized into two groups.32patients received alpha interferon and lamivudine simultaneously for9months,then lamivudine alone for15monthos;32patients received lamivudine alone for24months.Their curative effects were evaluated by biochemical and virological parameters,the YMDD mutation was detected by PCR.Results:The normalization rate of ALTwas90.6%(29/32)in the combination group and87.5%(28/32)inˉlamivudine group,there was no significant difference(P0.05);The rate of HBeAg negative conversion was68.8%(22/32)in the combination group and37.5%(12/32)in lamivudine group,with significant difference(P0.05);The rate of HBeAg/anti-HBe seroconversion was53.1%(17/32)in the combination group and25%(8/32)in lamivudine group,with significant difference(P0.05);The rate of HBV DNA negative conversion was78.1%(25/32)in the combination group and59.4%(19/32)in lamivudine group,without significant difference(P0.05);The rate of YMDD mutation was21.9%(7/32)in combination group and40.6%(13/32)in lamivudine group,without significant difference(P0.05).At the same time,the rates of ALT normalization,HBeAg/anti-HBe seroconversion and HBV DNA negative conversion were assoˉciated with their baseline before treatment.Conclusion:The long-term effect of lamivudine combined with alpha interferon for treating chronic hepatitis Be antigen-positive hepatitis B is superior to that onlywith lamivudine,especially in patients with ALTmoderate elevation and high level replication of HBV DNA.Combination theray may delay or diminish the development of YMDD mutation-related resistance to lamivudine.