Iranian Journal of Clinical Infectious Disease 2006;1(2):5-10 Iranian Journal of Clinical Infectious Diseases 2006;1(2):5-10 ©2006 IDTMRC, Infectious Diseases and Tropical Medicine Research Center Comparing the efficacy of alpha-interferon and lamivudine in patients with chronic hepatitis B Mostafa Alavimoghaddam 1 , Seyed Moayyed Alavian 2 , Davood Yadegarynia 1 1 Infectious Disease and Tropical Medicine Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran 2 Department of Gastroenterology, Baghiyatollah University of Medical Sciences, Iran ABSTRACT Background: Hepatitis B virus (HBV) infection is a worldwide health concern. Alpha-interferon and lamivudine have been approved for HBV patients; however, their efficacy remains a matter of controversy. The present study compares these two antiviral regimens in a group of Iranian patients with hepatitis B. Materials and methods: It was a randomized controlled clinical trial. Totally, 32 newly diagnosed hepatitis B patients were assigned in 2 groups of lamivudine (100mg per day orally) and alpha-interferon 2a (9 million units every other days subcutaneously). Both groups were evaluated at weeks 0,1,2,4, and monthly after till the 6 th month at Tehran Hepatitis Center. HBV DNA, HBeAg, anti-HBe, ALT activity, liver biopsy according to Knodell scoring system and drug side effects were determined, when appropriate. Results: The mean age of the patients was 31.4 ±8.8 years. PCR studies revealed negative in 13 (81.3%) interferon- and 15 (93.8%) lamivudine-treated subjects after 6 months of therapy. Among 17 patients with ALT activity of less than 70IU/l prior to therapy, 9 (90%) interferon- and 7 (100%) lamivudine-treated patients were found to have negative PCR results following the therapy (p<0.001). Primary response to therapy was detected in 3 interferon- and 6 lamivudine- treated subjects, while secondary response was reported in 8 (50%) interferon- and 12 (75%) lamivudine-treated patients. No lamivudine-associated side effect was demonstrated. Conclusion: Lamivudine is a well-tolerated cost-effective antiviral drug for hepatitis B patients. It could be prescribed as the initial drug for patients with chronic hepatitis B. Keywords: Hepatitis B, Lamivudine, Alpha-Interferon. (Iranian Journal of Clinical Infectious Diseases 2006;1(2):5-10). INTRODUCTION 1 Hepatitis B virus (HBV) infection is a global health concern with an estimated 300 million HBV carriers worldwide (1). It is among the first 9 Received: 3 August 2005 Accepted: 7 September 2005 Reprint or Correspondence: Davood Yadegarynia, MD. Infectious Diseases and Tropical Medicine Research Center, Shaheed Beheshti University of Medical Sciences, Tehran. E-mail: nebrahimi@sina.tums.ac.ir prevalent causes of death worldwide. Prior studies have addressed the use of alpha-interferon in acute HBV infection (2); however, the rate of successful treatment (disappearance of HBeAg and appearance of anti-HBe) was reported 40% at the most (3). Nevertheless, female gender and patients with high baseline alanine aminotransferase (ALT) activity are more likely to respond to interferon (4). ORIGINAL ARTICLE