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Prolonged Combination Therapy is More Effective than Monotherapy in Management of Chronic Hepatitis B Patients With Sustained Virological Response: An Experience From a ‘Real-World’ Clinical Setting

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En Qiang Chen 1 , 2 , * , Lang Bai 1 , 2 , Lan Lan Chen 1 , 2 , Tao You Zhou 1 , 2 , Ling Yao Du 1 , 2

1 Center of Infectious Diseases, West China Hospital, Sichuan University, China

2 Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, China

How to Cite: Qiang Chen E, Bai L, Chen L L, Zhou T Y, Yao Du L. Prolonged Combination Therapy is More Effective than Monotherapy in Management of Chronic Hepatitis B Patients With Sustained Virological Response: An Experience From a ‘Real-World’ Clinical Setting, Iran Red Crescent Med J. 2013 ; 15(12):e95984. doi: 10.5812/ircmj.7788.

ARTICLE INFORMATION

Iranian Red Crescent Medical Journal: 15 (12); e95984
Published Online: December 05, 2013
Article Type: Research Article
Received: July 03, 2019
Accepted: October 29, 2013
DOI : 10.5812/ircmj.7788
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Abstract

Background:: Little is known about the duration of combination therapy for patients with chronic hepatitis B (CHB) and suboptimal response to nucleos(t)ide analogues(NAs) monotherapy.

Objectives:: This study aimed to assess whether monotherapy could be used for treatment of CHB patients, who poorly responded to Adefovir Dipivoxil (ADV) but obtained good responses after at least 12-month lamivudine (LAM) or telbivudine (LdT) add-on therapy.

Patients and Methods:: Forty-five patients were enrolled, and the baseline time-point was determined according to enrollment data. Twenty-six patients chose to continue combination therapy (LAM+ADV or LdT+ADV, Group A) and 19 patients switched to single-drug maintenance therapy (LAM or LdT or ADV, Group B).

Results:: There were no significant differences between two groups in baseline characteristics (P > 0.05). At 12th month, sustained virological response rate was greater in group A compared to group B (96.2% vs. 47.4%, P < 0.001), and the rates of NAs-associated resistance were 0% in group A and 15.8% in group B. Alanine aminotransferase normalization rate was also significantly higher in group A compared with group B (92.3% vs. 36.8%, P < 0.001). Among hepatitis positive patients with Be antigen (HBeAg)-, 40% (4/10) in group A and 9.1% (1/11) in group B achieved HBeAg seroconversion at the 12th month. Of patients in group B with positive-HBeAg before the previous combination therapy and detectable HBV DNA at 6 months of previous combination therapy were associated with high risks of viral relapse after switching to single-drug maintenance therapy.

Conclusions:: Prematurely switching to single-drug maintenance therapy would be resulted in viral relapse, and prolonged combination therapy was effective to maintain sustained responses for patients with initial suboptimal response to ADV.

Keywords

Hepatitis B Chronic Combined Modality Therapy Hepatitis Be Antigens

© 2013, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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