Efficacy of pegylated interferon α2a in patients without HBeAg loss after the withdrawal of long-term lamivudine therapy

BACKGROUND: Improving the HBe seroconversion rate of patients without HBeAg loss after long-term lamivudine therapy has become an urgent clinical problem that we have to face. Unfortunately, there is no consensus on the mananement of these patients. The aim of this study was to evaluate the efficacy of pegylated interferon (PEG-IFN) α2a in patients without HBeAg loss after the withdrawal of long-term lamivudine therapy. METHODS: Fifty patients with chronic hepatitis B without the loss of HBeAg after ≥96 weeks of lamivudine treatment were enrolled to withdraw from treatment to induce a biochemical breakthrough. Patients who achieved a biochemical breakthrough within 24 weeks received 48-weeks of PEG-IFN α2a therapy, and were then assessed during a subsequent 24-week follow-up period. RESULTS: Forty-three (86.0%) patients achieved a biochemical breakthrough within 24 weeks of lamivudine withdrawal. The rates of combined response (both undetectable HBV DNA and HBeAg loss) and HBsAg loss were alone 51.2% and 20.9%, respectively after 48 weeks of PEG-IFN α2a therapy, and 44.2% and 18.6%, respectively, at 24 weeks after treatment cessation. The end-of-treatment combined response rate was 65.4% among patients with a baseline HBsAg <20,000 IU/mL, which was significantly higher than 29.4% of patients with HBsAg ≥20,000 IU/mL (P=0.031). For patients with HBsAg levels <1,500 IU/mL at 12 and 24 weeks therapy, the end-of-treatment combined response rate was 68.2% and 69.0%, which were both significantly higher than patients with HBsAg ≥1,500 IU/mL (33.3% and 14.3%; P=0.048 and 0.001). The end-of-treatment combined response rate was significantly higher among patients with HBV DNA<10(5) copies/mL (76.2%) compared to patients with HBV DNA ≥10(5) copies/mL (27.3%) after 24 weeks of therapy (P=0.004). CONCLUSION: Retreatment with PEG-IFN α2a was effective and safe for patients without HBeAg loss after the withdrawal of long-term lamivudine therapy. HBsAg levels at the baseline, 12 and 24 weeks of therapy, and HBV DNA levels at 24 weeks of therapy, can predict the effect of PEG-IFN α2a after 48 weeks of therapy

Production of proton-rich nuclei around Z=84-90 in fusion-evaporation reactions

Within the framework of the dinuclear system model, production cross sections of proton-rich nuclei with charged numbers of Z=84-90 are investigated systematically. Possible combinations with the $^{28}$Si, $^{32}$S, $^{40}$Ar bombarding the target nuclides $^{165}$Ho, $^{169}$Tm, $^{170-174}$Yb, $^{175,176}$Lu, $^{174,176-180}$Hf and $^{181}$Ta are analyzed thoroughly. The optimal excitation energies and evaporation channels are proposed to produce the proton-rich nuclei. The systems are feasible to be constructed in experiments. It is found that the neutron shell closure of N=126 is of importance during the evaporation of neutrons. The experimental excitation functions in the $^{40}$Ar induced reactions can be nicely reproduced. The charged particle evaporation is comparable with neutrons in cooling the excited proton-rich nuclei, in particular for the channels with $\alpha$ and proton evaporation. The production cross section increases with the mass asymmetry of colliding systems because of the decrease of the inner fusion barrier. The channels with pure neutron evaporation depend on the isotopic targets. But it is different for the channels with charged particles and more sensitive to the odd-even effect.Comment: 15 pages, 10 figures. arXiv admin note: text overlap with arXiv:0803.1117, arXiv:0707.258