When the 2nd-line treatment failed or H. pylori recurred, the unused MA or QUAD was used as a third-line treatment. Eighty-six patients had recurrence at least once during consecutive lines of treatments. Among 2,116 patients (intention-to-treat, ITT) without recurrence, 1,644 (77.7%, per-protocol, PP) completely followed our treatment flow. The ITT and PP rates of first line treatment were 69.8% and 89.3%. After second line, they reached 78.4% (ITT) and 98.4% (PP). The ′final′ eradication rate up to 3rd line treatment were 80.0% (1692/2116) and 99.8% (1641/1644), respectively. Resistance
to clarithromycin showed significantly lower eradication rate (OR 0.358, P<0.001) than those with susceptible strains in multivariate analysis. However in PP analysis, there was no significant difference in ultimate success
rate regarding resistance pattern. Final success EPZ-6438 order rate of PP was high, 99.8% in Korea in spite of high antibiotic resistance rates. However, high rate of refusal of further treatment and follow-up loss made ITT eradication rate low. Proper strategy to improve the treatment adherence is needed. “
“Background and Aims: Lamivudine, a nucleoside analog, is commonly used for treatment of chronic hepatitis B (CHB) but its durability of effectiveness after withdrawal is still uncertain. This study was click here designed to assess the durability of lamivudine treatment with stringent cessation criteria in hepatitis B e antigen (HBeAg)-negative patients and to explore potential predictive factors. Methods: Sixty one HBeAg-negative CHB patients who had received lamivudine for at least 24 months and had maintained undetectable serum hepatitis 上海皓元 B virus (HBV) DNA plus normal alanine aminotransferase for ≥ 18 months before withdrawal were included. They were followed up monthly during the first 4 months and at 3-month or 6-month intervals thereafter. Relapse was defined as serum HBV DNA ≥ 104 copies/mL. Results: Thirty one of 61 patients relapsed
during follow-up, over 90% occurred within 18 months after lamivudine withdrawal. Cumulative relapse rates at months 6, 12, 24, 36, 48 and 60 were 26.2%, 43.6%, 49.7%, 52.1%, 56.1% and 56.1%, respectively. Cox regression revealed that age was the only predictive factor for relapse, with lower relapse rates found in younger patients. Hepatitis B surface antigen (HBsAg) turned negative in eight patients, and none of them relapsed during follow-up. Conclusion: Effectiveness of lamivudine treatment is not durable in HBeAg-negative CHB patients even when stringent cessation criteria are adopted, with the exception of patients aged ≤ 20 years. The ideal end point of lamivudine treatment is clearance of serum HBsAg. “
“Pegylated interferon-alpha2/ribavirin (peg-IFN/RBV) is the standard of care (SOC) for patients with chronic hepatitis C (CHC) infection. Currently, direct-acting antiviral agents (DAAs) are evaluated in clinical trials.