Browsing by Author "Hadziyannis, Stephanos"
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Item Factors associated with sustained virologic response 1 year after treatment with peginterferon alfa-2A (40KD) (PEGASYS (R)) monotherapy for HBEAG-negative chronic hepatitis B(Wiley, 2005-10) Patrick, Marcellin; Ferruccio, Bonino; Lau, Grace; Patrizia, Farci; Yurdaydın, Cihan; Piratvisuth, Teerha; Jin, Rui; Hadziyannis, Stephanos; Lu, Zhi-Meng; Popescu, Matei; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.Item Peginterferon alfa-2a alone, lamivudine alone, and the two in combination in patients with HBeAg-negative chronic hepatitis B(Massachusetts Medical Soc, 2004-09-16) Marcellin, Patrick; Lau, George; Bonino, Ferruccio; Farci, Patrizia; Hadziyannis, Stephanos; Jin, R.; Lu, ZM; Piratvisuth, Teerha; Germanidis, Georgios; Yurtaydin, Cihan; Moises, Diago; Mingyang, Lai; Button, P.; Pluck, Nigel; Gurel, Selim; Bursa Uludağ Üniversitesi/Tıp Fakültesi.Background: Available treatments for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B are associated with poor sustained responses. As a result, nucleoside and nucleotide analogues are typically continued indefinitely, a strategy associated with the risk of resistance and unknown long-term safety implications. Methods: We compared the efficacy and safety of peginterferon alfa-2a (180 microg once weekly) plus placebo, peginterferon alfa-2a plus lamivudine (100 mg daily), and lamivudine alone in 177, 179, and 181 patients with HBeAg-negative chronic hepatitis B, respectively. Patients were treated for 48 weeks and followed for an additional 24 weeks. Results: After 24 weeks of follow-up, the percentage of patients with normalization of alanine aminotransferase levels or hepatitis B virus (HBV) DNA levels below 20,000 copies per milliliter was significantly higher with peginterferon alfa-2a monotherapy (59 percent and 43 percent, respectively) and peginterferon alfa-2a plus lamivudine (60 percent and 44 percent) than with lamivudine monotherapy (44 percent, P=0.004 and P=0.003, respectively; and 29 percent, P=0.007 and P=0.003, respectively). Rates of sustained suppression of HBV DNA to below 400 copies per milliliter were 19 percent with peginterferon alfa-2a monotherapy, 20 percent with combination therapy, and 7 percent with lamivudine alone (P<0.001 for both comparisons with lamivudine alone). Loss of hepatitis B surface antigen occurred in 12 patients in the peginterferon groups, as compared with 0 patients in the group given lamivudine alone. Adverse events, including pyrexia, fatigue, myalgia, and headache, were less frequent with lamivudine monotherapy than with peginterferon alfa-2a monotherapy or combination therapy. Conclusions: Patients with HBeAg-negative chronic hepatitis B had significantly higher rates of response, sustained for 24 weeks after the cessation of therapy, with peginterferon alfa-2a than with lamivudine. The addition of lamivudine to peginterferon alfa-2a did not improve post-therapy response rates.Item Sustained response of Hepatitis B e Antigen-Negative patients 3 years after treatment with Peginterferon Alfa-2a(WB Saunders Co-Elsevier, 2009-06) Yurdaydın, Cihan; Marcellin, Patrick; Bonino, Ferruccio; Lau, George; Farci, Patrizia; Piratvisuth, Teerha; Jin, Rui; Lu, Zhi-Meng; Wu, Jian; Popescu, Matei; Hadziyannis, Stephanos; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 7003706434Background & Aims: Patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B treated with peginterferon alfa-2a with or without lamivudine achieve significantly higher 6-month posttreatment rates of response compared with those treated with lamivudine alone. The durability of <= 3-year posttreatment response was investigated in this study. Methods: Patients received peginterferon alfa-2a only (180 p,g once weekly; n = 177), in combination with lamivudine (100 mg daily; n = 179) or lamivudine alone (n = 181) for 48 weeks. A total of 315 patients (116, 114, and 85, respectively) participated in this posttreatment observational study. Results: Three years after treatment, the percentage of patients with normal alanine aminotransferase (ATL) was higher for patients treated with peginterferon alfa-2a (31%) than with lamivudine (18%; P = 0.032). Similarly, 28% of patients treated with peginterferon had hepatitis B virus (HBV) DNA levels 10,000 copies/mL versus 15% of patients treated with lamivudine (P = .039). Peginterferon alfa-2a treatment and high baseline ALT level were independent baseline predictors of long-term virologic response (P = .040 and P = .01, respectively). Of the patients who had been treated with a peginterferon alfa-2a-containing regimen, 8.7% cleared hepatitis B surface antigen (HBsAg; 44% of those with undetectable HBV at 3-year posttreatment follow-up) compared with none treated with lamivudine alone. Conclusions: Biochemical and virologic responses were sustained for 53 years in approximately 25% of patients given a 48-week course of peginterferon alfa-2a, with or without lamivudine. The increased rate of HBsAg clearance in patients with HBeAg-negative chronic hepatitis B supports the use of peginterferon alfa-2a as a first-line treatment.