Objective:To investigate whether combining the antiviral effect of lamivudine with the immune-boosting action of interferon-alpha(IFN-α)is effective in treating hepatitis b virus(HbV)“immunotolerant”*** design:Twen...
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Objective:To investigate whether combining the antiviral effect of lamivudine with the immune-boosting action of interferon-alpha(IFN-α)is effective in treating hepatitis b virus(HbV)“immunotolerant”*** design:Twen tythree children(8 boys;mean age,10 years)infected during the first year of life(17 Asian,21 with normal aminotransferase levels,15 with HbV-dna > 1000 pg/mL by hybridization and all with mild histologic changes)were treated with l amivudine(3 mg/kg)for 8 weeks alone and then lamivudine(3 mg/kg)-and IFN-α(5 MU/m2,3 times weekly)in combination for 10 ***:Seventy-eight percent became HbV-dna negative at the end of treatment,5(22%)seroconverted to anti-Hbe,4(17%)of whom achieved complete viral control,becoming persis tently HbsAg negative and anti-Hbs *** had YMDD *** viral status of the patients has not changed after a median follow-up of 40 months(range,36 to 48).Conclusions:This pilot study suggests that lamivudine pretrea tment followed by a combination of lamivudine and IFN-αcan induce complete vir al control in HbV immunotolerant children,hitherto considered poor responders.
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