Effectiveness of Lamivudine and Interferon for Treating Hepatitis B Patients

Do medications like lamivudine and interferon have therapeutic effects for patients with hepatitis B?

I would like to ask whether medications like lamivudine and interferon are effective for patients with hepatitis B.
I saw online that lamivudine was originally used to treat HIV, but later it was noted that HIV patients with co-infection of hepatitis B experienced a decrease in hepatitis B virus levels and relief from liver inflammation after receiving lamivudine.
Can these types of medications be used for hepatitis B patients? Also, is interferon only used for children with e-antigen positive and abnormal liver function, and not for adults or adolescents? What medications are currently available for hepatitis B patients in Taiwan?

Lanlan- Mo'ni, 10~19 year old female. Ask Date: 2004/12/10

Dr. Chen Zhiping reply Gastroenterology and Hepatology

Hello, these two medications are currently used for the treatment of chronic hepatitis B.
For patients with long-term abnormal liver function tests, Lanivudine (also known as Lamivudine) can be administered orally, or interferon can be given via injection, depending on the situation.
This treatment is applicable to both HBeAg-positive and HBeAg-negative patients, and is not limited to children; adults can also be treated.
However, it is not 100% effective.
Currently, the National Health Insurance in Taiwan only allows conditional use of these medications for patients who are expected to benefit significantly or for those with severe conditions that require prompt treatment; otherwise, patients must pay out of pocket.
In addition to these two medications, Adefovir is also available for oral use in Taiwan, but it is not considered first-line treatment.
It is used only when the first-line treatments fail or when drug-resistant viruses develop, and this medication is more expensive.
Sincerely, Dr.
Chen Zhi-Ping, Internal Medicine.

Reply Date: 2004/12/10

More Info

Lamivudine and interferon are two important treatment options for patients with chronic Hepatitis B virus (HBV) infection. Both have been shown to have therapeutic effects, although their mechanisms of action and effectiveness can vary based on the patient's specific circumstances.

Lamivudine is a nucleoside analog that was initially developed for the treatment of HIV. However, it has been found to be effective in treating HBV as well. When used in patients with chronic Hepatitis B, lamivudine works by inhibiting the reverse transcriptase enzyme, which is crucial for the replication of the virus. Clinical studies have demonstrated that lamivudine can lead to a significant reduction in HBV DNA levels, which correlates with a decrease in liver inflammation and improvement in liver function tests.
In your observation regarding HIV patients with co-infection of HBV, it is indeed true that lamivudine can lead to a decrease in HBV viral load. This is because the drug is effective against both viruses, although its primary indication is for HIV. However, it is important to note that the long-term use of lamivudine can lead to the development of drug resistance, particularly in patients who have high baseline viral loads or who do not achieve adequate viral suppression. Therefore, while lamivudine can be a viable option for treating HBV, it is often used in combination with other antiviral agents, such as adefovir or tenofovir, to mitigate the risk of resistance.

Interferon, on the other hand, is a type of immunotherapy that enhances the body's immune response against the virus. It is typically administered as an injection and can be effective in achieving a sustained virological response in some patients, particularly those who are HBeAg positive and have high levels of HBV replication. Interferon therapy is not limited to children; it can also be used in adults and adolescents. However, its use is often restricted to patients with certain profiles, such as those with significant liver inflammation or fibrosis, due to its side effects and the need for careful monitoring.

In Taiwan, the treatment landscape for chronic Hepatitis B includes several antiviral medications. Besides lamivudine and interferon, other options include adefovir and tenofovir. Tenofovir is particularly noteworthy as it is considered a first-line treatment due to its high efficacy and lower risk of resistance compared to lamivudine.
Patients with chronic Hepatitis B should be regularly monitored for liver function and viral load, and treatment decisions should be based on individual factors such as liver enzyme levels, HBV DNA levels, and the presence of liver fibrosis.
In summary, both lamivudine and interferon can be effective in treating Hepatitis B, but their use should be tailored to the individual patient. Regular monitoring and possibly combination therapy may be necessary to achieve the best outcomes and minimize the risk of resistance. If you or someone you know is considering treatment for Hepatitis B, it is crucial to consult with a healthcare provider who specializes in liver diseases to determine the most appropriate treatment plan.

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