Peginterferon Alfa-2a Alone, Lamivudine Alone, and the Two in Combination in Patients with HBeAg-Negative Chronic Hepatitis B

Among patients with hepatitis B e antigen (HBeAg)–negative chronic hepatitis B, the rates of suppression of hepatitis B virus DNA to below 20,000 copies per milliliter were 43 percent with peginterferon alfa-2a alone, 44 percent with peginterferon alfa-2a plus lamivudine, and 29 percent with lamivudine alone after 48 weeks of treatment and 24 weeks of follow-up; the rates of suppression to below 400 copies per milliliter were 19 percent, 20 percent, and 7 percent, respectively. Peginterferon alfa-2a was more effective than lamivudine for HBeAg-negative chronic hepatitis B. Chronic infection with hepatitis B virus (HBV) is a major global health problem, affecting more than 400 million people worldwide. 1 Chronic hepatitis B is associated with serious complications, including liver failure, cirrhosis, and hepatocellular carcinoma. Hepatitis B e antigen (HBeAg)–negative chronic hepatitis B represents a late phase of the infection that is characterized by progressive liver damage 2 , 3 and viral variants with changes in the precore or core promoter region, 4 , 5 which abolish or suppress the expression of HBeAg. Spontaneous, sustained remissions are rare in HBeAg-negative chronic hepatitis B, 6 which has a poor prognosis. HBeAg-negative chronic hepatitis B occurs throughout . . .