***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Short-term interferon treatment of serum hepatitis B e antigen (HBeAg)-negative carriers with serum hepatitis B virus ( HBV ) DNA and histological features of chronic hepatitis B has been largely unsuccessful . In a pilot study of long-term treatment , 42 such patients were r and omly assigned to 6 million units of interferon alfa 2b ( IFN-alpha2b ) three times per week for 24 consecutive months ( n = 21 , 4 with cirrhosis ) or to no therapy ( n = 21 , 3 with cirrhosis ) . Five patients ( 24 % ) discontinued therapy because of treatment-related adverse reactions . Serum levels of alanine transaminase ( ALT ) became persistently normal and HBV DNA undetectable by dot-blot assay in 8 patients receiving interferon and in 2 untreated controls ( 38 % vs. 10 % ; P = .03 ) . Hepatitis flare-ups disappeared in 17 patients during therapy compared with 6 controls ( 81 % vs. 29 % ; P < .001 ) . During a median period of 22 months after interferon was stopped , 2 treated patients ( 10 % ) lost serum hepatitis B surface antigen ( HBsAg ) and seroconverted to antibodies to hepatitis B surface antigen ( anti-HBs ) . Serum ALT remained persistently normal and HBV DNA undetectable by dot-blot assay in 6 initial responders and 1 initial nonresponder , compared with none of the 21 untreated controls ( sustained response : 33 % vs. 0 ; P < .001 ) . Comparative analysis of pre- and posttreatment liver biopsies showed that mean Knodell scores dropped in the treated group ( 10.3 to 5.3 ; P = .01 ) , but not in the untreated group ( 9.3 to 9.8 ; not significant ) . In conclusion , a 24-month course of treatment with 6 MU IFN-alpha2b was well tolerated by most patients , led to sustained suppression of HBV in one third , and attenuated hepatitis in 81 % of patients Current therapies for chronic hepatitis B ( CHB ) have a number of limitations , and better treatment options are needed . Peginterferon alpha-2a ( 40 kDa ) is superior to conventional interferon alpha-2a in the treatment of chronic hepatitis C. This is the first report on peginterferon alpha-2a ( 40 kDa ) in the treatment of CHB . In this phase II study , 194 patients with CHB not previously treated with conventional interferon-alpha were r and omized to receive weekly subcutaneous doses of peginterferon alpha-2a ( 40 kDa ) 90 , 180 or 270 microg , or conventional interferon alpha-2a 4.5 MIU three times weekly . Twenty-four weeks of therapy were followed by 24 weeks of treatment-free follow-up . All subjects were assessed for loss of hepatitis B e antigen ( HBeAg ) , presence of hepatitis B antibody ( anti-HBe ) , suppression of hepatitis B virus ( HBV ) DNA , and normalization of serum alanine transaminase ( ALT ) after follow-up . At the end of follow-up , HBeAg was cleared in 37 , 35 and 29 % of patients receiving peginterferon alpha-2a ( 40 kDa ) 90 , 180 and 270 microg , respectively , compared with 25 % of patients on conventional interferon alpha-2a . The combined response ( HBeAg loss , HBV DNA suppression , and ALT normalization ) of all peginterferon alpha-2a ( 40 kDa ) doses combined was twice that achieved with conventional interferon alpha-2a ( 24%vs 12 % ; P = 0.036 ) . All treatment groups were similar with respect to frequency and severity of adverse events . These results indicate that peginterferon alpha-2a ( 40 kDa ) is superior in efficacy to conventional interferon alpha-2a in chronic hepatitis B based on clearance of HBeAg , suppression of HBV DNA , and normalization of ALT A r and omized controlled trial of recombinant interferon alfa-2b has been initiated in patients with chronic active hepatitis who were negative for serum hepatitis B e antigen but positive for serum hepatitis B virus DNA and hepatitis B core antigen expression in the liver . Twenty-five patients received interferon alfa-2b 3 million units thrice weekly for 14 - 16 weeks and 25 served as untreated controls . Seventeen patients in the treatment and 18 in the control group have already completed a 12-month period of observation . Interferon alfa-2b was well tolerated by all patients . At the end of therapy , complete responses , defined as disappearance of hepatitis B virus DNA from serum and return of alanine aminotransferase to normal , were observed in 10 ( 59 % ) of the 17 treated patients compared to none in the control group ( p less than 0.01 ) . Twelve months after the onset of interferon alfa-2b therapy , 11 ( 65 % ) of the 17 treated patients were complete responders compared to 2 ( 11 % ) of 18 in the control group ( p less than 0.01 ) . Fifty per cent ( 4/8 ) of complete responders to interferon alfa-2b therapy , followed for 16 - 24 months , experienced reactivations of hepatitis B virus replication with reappearance of serum hepatitis B virus DNA and a return of serum alanine aminotransferase activity . The response to interferon alfa-2b therapy appeared to be independent of pre-treatment serum alanine aminotransferase and hepatitis B virus DNA levels In a multicentre trial , 82 patients known to be hepatitis B e antigen and hepatitis B virus DNA positive for at least 1 year , with elevated serum alanine aminotransferase levels and chronic liver lesions on biopsy , were r and omized to receive either recombinant interferon alfa-2a  at a dose of 4.5 million units thrice weekly for 4 months or no treatment . At the end of therapy , viral DNA clearance and aminotransferase normalization were significantly ( p less than 0.05 ) more frequent in treated patients than in controls . After 16 months ' follow up , the difference was still significant for hepatitis B e antigen clearance and transaminase normalization . Hepatitis B virus DNA reactivation was observed during follow up in 43 % of treated patients and 50 % of controls . Improvements in liver inflammation were observed in patients on interferon . High pre-treatment serum aminotransferase levels , female sex and a low score for fibrosis in the initial biopsy were predictive factors significantly ( p less than 0.05 ) associated with termination of hepatitis B virus replication in treated cases . These results indicate that interferon is effective in inducing clearance of HBV from serum and improvement of biochemical and histological parameters of liver disease . However , a more prolonged regimen of therapy may be required to obtain stable suppression of hepatitis B virus replication A total of 58 patients with histologically confirmed chronic viral hepatitis B and presence of hepatitis B surface antigen and hepatitis B virus DNA ( HBV DNA ) in the serum were r and omized in a prospect ively controlled trial . Thirty patients were treated with 3 megaunits of recombinant interferon alfa-2b ( INTRON A , R Schering-Plough , Essex Corporation ) subcutaneously thrice weekly for 4 months . Twenty-eight controls received no treatment . The post-treatment follow-up period consisted of 6 months . Twenty-eight treated patients and 27 controls completed the protocol . One female patient of the treatment group showed a complete response , and eight other treated patients ( 32 % ) showed a partial response to therapy . Three patients in the control group ( 11 % ) lost hepatitis B e antigen and HBV DNA spontaneously . This finding is statistically significant ( p less than 0.05 ) . The elimination of hepatitis B virus markers from the serum was associated with a normalization of aminotransferase activities in the serum . Reactivation of hepatitis was not observed after seroconversion To determine the antiviral effect of recombinant-interferon (rIFN)-alpha in hepatitis B virus ( HBV ) chronic infection , a controlled study was carried out . A total of 20 HBsAg chronic carriers ( 18 chronic active hepatitis and 2 chronic persistent hepatitis ) were included . All of them had remained HBeAg , HBV-DNA and HBV-DNA polymerase ( HBV-DNAp ) positive at least six months before treatment . The patients were r and omly assigned to two groups : control ( n = 10 ) , and treatment ( n = 10 ) . A dose of 5.5 megaunits of rIFN-alpha/m2 body surface was administered every day for 21 days ( induction ) and twice a week for six months thereafter ( maintenance ) . No basal differences were observed between the two groups . No case of intolerable toxicity was observed . One treated patient died in a car crash in the second month . At the end of the first week of therapy , 7/10 ( 70 % ) of the treated patients became HBV-DNAp negative . However , in the fifth month only 2 patients remained HBV-DNAp negative and also became HBV-DNA and HBeAg negative . In contrast , no changes in viral markers among control cases were observed . In conclusion , rIFN-alpha has an antiviral effect on chronic HBV infection ; however , the induction plus maintenance schedule is not useful to obtain a permanent effect Interferon alfa ( IFN‐α ) is the primary treatment for chronic hepatitis B. The st and ard duration of IFN‐α therapy is considered 16 weeks ; however , the optimal treatment length is still poorly defined . We evaluated the efficacy and acceptability of prolonged IFN‐α treatment in patients with chronic hepatitis B. To investigate whether treatment prolongation could enhance the rate of hepatitis B e antigen ( HBeAg ) seroconversion , we conducted a prospect i ve , controlled , multicenter trial in which all patients were treated with a st and ard regimen of 10 million units IFN‐α 3 times per week over 16 weeks . Patients who were still HBeAg‐positive after 16 weeks of therapy were r and omized to prolongation of the identical regimen up to 32 weeks ( prolonged therapy ) or discontinuation of treatment ( st and ard therapy ) . Among the 162 patients who entered the study , 27 ( 17 % ) were HBeAg‐negative after the first 16 weeks of treatment , and 118 were r and omized to st and ard or prolonged therapy . After r and omization , a response ( HBeAg seroconversion and sustained hepatitis B virus [HBV]‐DNA negativity ) was observed in 7 of the 57 ( 12 % ) patients assigned to st and ard therapy versus 17 of the 61 ( 28 % ) patients assigned to prolonged therapy ( P = .04 ) . A low level of viral replication after 16 weeks of treatment , as indicated by serum HBV‐DNA values under 10 pg/mL , was found to be the only independent predictor of response ( 52 % vs. 0 % ; P < .001 ) during prolonged therapy . The prolonged IFN‐α schedule was well tolerated in the large majority of patients . In chronic hepatitis B , prolongation of IFN‐α therapy up to 32 weeks is superior to a st and ard course of 16 weeks . Those patients who exhibit a low level of viral replication at the end of the st and ard regimen benefit most from prolonged treatment 72 Chinese patients who had been positive for hepatitis B surface antigen ( HBsAg ) and hepatitis B e antigen ( HBeAg ) for more than six months with stable serum hepatitis B virus DNA were r and omised to receive recombinant alpha 2-interferon at doses of 2.5 , 5 , or 10 X 10(6 ) U/m2 intramuscularly thrice weekly for 12 - 24 weeks , or no treatment . 6 ( 11 % ) of 54 treated and 1 ( 6 % ) of 18 control patients became HBeAg-negative at the end of therapy or after 24 weeks of follow-up . 9 ( 17 % ) of treated but none of the control patients became HBeAg-negative between completion of therapy and 12 months . Reactivation of HBV replication subsequently occurred in 7 ( 13 % ) of the treated patients and in 1 control . Thus , sustained clearance of HBeAg was achieved only in 8 ( 15 % ) of treated patients at 12 months . Between 12 and 24 months 3 ( 9 % ) of treated patients and 1 control became negative for HBeAg . None of the patients became HBsAg-negative .  alpha 2-interferon in the dose regimen used has little long-term effect in the suppression of HBV replication in Chinese patients with chronic HBV infection Hepatitis B virus ( HBV ) infection after liver transplantation ( LT ) may lead to severe and rapidly progressive graft failure . Antiviral treatment may be of benefit in selected patients with recurrent hepatitis B post-LT . The aim of this prospect i ve open-label study is to determine the safety and efficacy of lamivudine in 33 liver transplant recipients with active HBV infection . The median time from LT to study enrollment was 51 months , all patients were hepatitis B surface antigen positive , and 75 % and 94 
    Output:
    
Presence or absence of HBeAg and pre-treatment alanine aminotransferase ( ALT ) levels were considered important factors in the initial therapeutic indication .
Treatment with conventional interferon enables lasting disease inactivation and can result in HBsAg seroconversion .
PEG2a showed better efficacy than interferon and LAM and similar side effects to interferon .
LAM presents advantages such as its sensitivity in the HbeAg-negative phenotype , while its main disadvantage is the development of resistance