Objectives:
We aimed to determine independent variables predictive of flare hepatitis in chronic hepatitis B-infected patients in whom virologic and biochemical response was obtained with nucleoside analogue or pegylated interferon therapy.
Methods:
This study was planned as a cross-sectional retrospective evaluation of data pertaining to chronic hepatitis B virus (HBV) cases. Patients’ body weight, height, gender, age, alcohol consumption, pretreatment serum HBV DNA and alanine aminotransferase levels, histopathologic activity index according to the Knodell scoring system, fibrosis score, treatment duration, biochemical and virologic response time to treatment, HBeAg status, presence of flare hepatitis, and drugs used in the HBV treatment were obtained from case files. Patients were divided into two groups as with and without flare hepatitis. These groups were compared in terms of the variables being assessed.
Results:
Sixty patients (18 female, 42 male) were included in this study. Flare hepatitis developed in 25 (41%) patients. The treatment durations of patients with flare hepatitis were longer than of the patients without flare hepatitis (22 months and 18 months, respectively, p=0.029). Eighteen of 42 patients treated with lamivudine, all patients treated with adefovir and none of 11 patients treated with interferon had flare hepatitis. Flare hepatitis was more common in the patients treated with adefovir than with lamivudine and interferon (p=0.01), and was more common in the patients treated with lamivudine than with interferon (p=0.01).
Conclusion:
We conclude that: 1-Prolonged duration of treatment increases the flare hepatitis rate, and 2-Flare hepatitis was more common in the patients treated with adefovir than with lamivudine and interferon. Furthermore, flare hepatitis was more common in the patients treated with lamivudine than with interferon.
Keywords: Flare hepatitis, hepatitis B virus