Improving the Odds for Hepatitis B

New research shows patients with hepatitis B may see more improvement with one drug alone rather than a combination of drugs. With currently available treatments, patients tend to relapse soon after being taken off the drugs. Therefore, they often stay medicated indefinitely despite a lack of knowledge about the risks of long-term treatment. Doctors are now searching for a drug that has longer-lasting results.

Researchers from around the world report patients with late stages of hepatitis B respond better to the medication peginterferon alfa-2a (Pegasys) than they do with a common medication called lamivudine (Epivir or Epivir-HBV) or a combination of the two. The latter drug is associated with resistance after long-term use. It appears the interferon offers more relief even after treatment stops.

Hepatitis B is a serious disease that attacks the liver and can cause chronic infection, cirrhosis of the liver, liver cancer, and death in up to a third of patients. Worldwide it affects more than 4 million people. In the United States, an estimated 1.25 million people are believed to have chronic hepatitis B, with approximately 100,000 new infections occurring annually.

The study was conducted by giving some patients peginterferon alfa-2a only, while others received lamivudine only, and a third group received a combination. Researchers report patients who received the interferon alone received the most benefit, and it lasted for as long as 24 weeks after treatment stopped. They recommend this be used as a “first-line therapy” for patients with end-stage hepatitis B.

SOURCE: The New England Journal of Medicine, 2004;351:1206-1217