Browsing by Author "Dikici B."

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    Current therapeutic approaches in childhood chronic hepatitis B infection: A multicenter study
    (Blackwell Publishing, 2004) Dikici B.; Ozgenc F.; Kalayci A.G.; Targan S.; Ozkan T.; Selimoglu A.; Doganci T.; Kansu A.; Tosun S.; Arslan N.; Kasirga E.; Bosnak M.; Haspolat K.; Buyukgebiz B.; Aydogdu S.; Girgin N.; Yagci R.V.
    Background and Aim: The aim of the present study was to compare the therapeutic efficacy of three different regimens in childhood chronic hepatitis B (CHB) infection. Methods: A total of 182 children with CHB infection were prospectively allocated to three random groups. Sixty-two patients in the first group received high-dose interferon (IFN)-α 2b (10 MU/m2) thrice/weekly alone for 6 months. In the second (n = 60) and third groups (n = 60), IFN-α was used for 6 months (5 MU/m2) thrice/weekly in combination with lamivudine (LAM) (4 mg/kg, maximum 100 mg/day) for 12 months. Lamivudine was started simultaneously with IFN in the second group, while it was started 2 months prior to IFN injections in the third group. Results: The initial mean alanine aminotransferase (ALT) values for the first, second and third groups were 109 ± 93 IU/L, 101 ± 64 IU/L and 92 ± 42 IU/L, respectively (P > 0.05). At the end of the therapy, ALT values decreased to 82 ± 111 IU/L, 38 ± 41 IU/L and 29 ± 16 IU/L in groups 1, 2 and 3, respectively. The mean ALT value of the first group was significantly different to the second and third groups (P = 0.046 and P = 0.002, respectively) at the end of the therapy and these differences were found to be sustained after 18 months. However, results in the second and third groups were similar (P > 0.05). There were no significant differences in HBeAg clearance and anti-HBe seroconversion at the initial stage, 12 months and 18 months between the three groups (P > 0.05). Hepatitis B virus (HBV) DNA clearance in the first group was different from the second and third groups, while the second and third groups had similar HBV DNA clearance ratios at 12 and 18 months. No significant difference was found in the complete response (normalization of ALT, clearance of HBV DNA and seroconversion of anti HBe) ratios of all groups (at 12 months: 28.8, 45.5, 35.8% and at 18 months 33.3, 49 and 34% in groups 1, 2 and 3, respectively, P > 0.05). Conclusions: Although the ALT normalization and HBV DNA clearance ratios of IFN plus LAM combination groups were better than the high-dose IFN-α monotherapy group, no significant difference was found in the complete response ratios of all three groups. © 2004 Blackwell Publishing Asia Pty Ltd.
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    Comparison of two different regimens of combined interferon-α2a and lamivudine therapy in children with chronic hepatitis B infection
    (2006) Kansu A.; Doǧanci T.; Akman S.A.; Artan R.; Kuyucu N.; Kalayci A.G.; Dikici B.; Dalgiç B.; Selimoǧlu A.; Kasirga E.; Özkan T.B.; Kuloǧlu Z.; Aydoǧdu S.; Boşnak M.; Ertekin V.; Tanir G.; Haspolat K.; Girgin N.; Yaǧci R.V.
    Aim: To evaluate the efficacy of two regimens of combined interferon-α2a (IFN-α2a) and lamivudine (3TC) therapy in childhood chronic hepatitis B. Methods: A total of 177 patients received IFN-α2a, 9 million units (MU)/m2 for 6 months. In group I (112 patients, 8.7±3.5 years), 3TC (4 mg/kg/day, max 100 mg) was started simultaneously with IFN-α2a, in group II (65 patients, 9.6±3.8 years) 3TC was started 2 months prior to IFN-α2a. 3TC was continued for 6 months after antiHBe seroconversion or stopped at 24 months in non-responders. Results: Baseline alanine aminotransferase (ALT) was 134.2±34.1 and 147.0±45.3; histological activity index (HAI) was 7.4±2.7 and 7.1±2.3; and HBV DNA levels were above 2,000 pg/ml in 76% and 66% of patients in groups I and II, respectively (P>0.005). Complete response was 55.3% and 27.6% in groups I and II, respectively (P<0.01). AntiHBe seroconversion was higher and earlier, and HBV DNA clearance was earlier in group I (P<0.05). HBsAg clearance was 12.5% and 4.6% and antiHBs seroconversion was 9.8% and 6.2% in groups I and II, respectively (P>0.05). Breakthrough occurred in 17.9% and 24.6%; breakthrough times were 15.9±4.6 and 14.1±5.1 months; and relapse rates were 6.8% and none in groups I and II, respectively (P>0.05, P>0.05, P>0.05). Responders had higher HAI (HAI>6) and higher pre-treatment ALT than non-responders. Conclusion: Simultaneous 3TC+IFN-α2a yields a higher response and earlier antiHBe seroconversion and viral clearance than consecutive combined therapy. Relapse rate is low. Predictors of response are high basal ALT and high HAI scores. 3TC can be administered for 24 months without any side effect and breakthrough rate is comparable with previous studies. © 2006 International Medical Press.