肝苏治疗慢性乙型肝炎的系统评价

目的系统评价肝苏治疗慢性乙型肝炎的疗效和安全性。方法计算机检索Cochrane图书馆临床对照试验数据库、PubMed、EMbase、CBM、CNKI、中文科技期刊数据库VIP和万方数据库等,检索时间从建库截至2009年12月按纳入排除标准选择文献,评价质量。在按测量指标和干预措施进行亚组分析后,对同质研究进行Meta分析。结果共纳入14个研究,合计1？755例慢性乙型肝炎患者。其中除2篇为半随机设计,其余12篇均未描述具体随机方法,所有文献均未描述分配隐藏方法,未实施盲法。Meta分析结果显示：①在降低ALT方面,肝苏＋常规治疗组优于常规治疗组,差异有统计学意义;②在HBsAg阴转率方面,肝苏＋常规治疗组与常规治疗组差异无统计学意义;③在HBeAg阴转率方面,治疗3个月时肝苏＋常规治疗组与常规治疗组比较差异无统计学意义;④在HBV-DNA阴转率方面,无论治疗3个月或6个月时,肝苏＋常规治疗组均优于常规治疗组,其差异有统计学意义,但肝苏＋拉米夫定/阿德福韦与单用拉米夫定/阿德福韦比较,两组差异无统计学意义;⑤在降低肝纤维化指标方面,肝苏＋常规治疗组优于常规治疗组,其差异有统计学意义。结论现有研究结果显示,肝苏治疗慢性乙型肝炎对ALT、病毒学指标、病毒学应答、肝纤维化的改善可能有效,且无严重不良反应。但本系统评价所纳入的文献多为较低质量的小样本研究,且用药时间不同,因此无法进行总体的效应合并分析,上诉结论尚需更多高质量研究支持。     

α-干扰素联合拉米夫定治疗儿童乙肝的Meta分析

目的 系统评价α-干扰素联合拉米夫定与单独应用α-干扰素治疗儿童乙肝患者的疗效及安全性.方法 计算机检索The Cochrane Library(2012年第4期)、PubMed、EMbase、Web of Science、CBM、CNKI、VIP和WanFang Data,检索时限均为从建库至2012年12月,并辅以手工检索,收集α-干扰素联合拉米夫定治疗儿童乙肝的随机对照试验(RCT).由两位研究者按照纳入和排除标准独立筛选试验、提取资料和评价方法学质量后,采用RevMan 5.0软件进行Meta分析.结果 共纳入8个RCT,各研究间基线均可比.Meta分析结果显示:与单用α-干扰素相比,α-干扰素联合拉米夫定组儿童乙肝患儿血清HBV-DNA阴转率[OR=4.17,95％CI (2.22,7.83),P＜0.000 01]和HBeAg阴转率[OR=5.22,95％CI (2.64,10.29),P＜0.000 01]均明显提高.而在血清抗-HBe阳转率、不良反应方面,两组差异无统计学意义.结论 当前证据显示,儿童乙肝患者应用α-干扰素联合拉米夫定的治疗方案优于单用α-干扰素治疗.     

多因素强化干预对新诊2型糖尿病患者生活质量和药物成本效果比的影响

目的 探讨多因素强化干预对新诊2型糖尿病患者生活质量、代谢指标达标率及药物成本-效果比的影响.方法 采用健康调查表SF-36对127例多因素强化干预及125例常规干预的2型糖尿病患者进行问卷调查,比较两组患者干预治疗前与干预治疗半年后生活质量的变化及血糖、血脂和血压的达标情况,对影响生活质量的某些因素进行多元逐步回归分析;并用成本-效果分析法对两组进行药物经济学评价.结果 强化干预组血糖、血脂、血压和总的达标率显著高于常规干预组(P＜0.05);强化干预组的躯体角色功能、一般健康感、生命活力、情感角色功能和综合评分均明显高于干预前(P＜0.05),干预治疗半年其VT评分和健康变化自评也优于常规组,而常规干预组干预治疗前后生活质量的各纬度评分无显著变化;生活质量综合评分干预治疗前后的差值与糖化血红蛋白的差值有关;强化干预组的降糖、调脂和降压的总成本-效果比和有关生活质量的总成本-效果比亦高于常规干预组.结论 多因素强化干预方案可提高新诊2型糖尿病患者血糖、血脂和血压达标率,改善其生活质量,并且比常规干预方案更经济.     

干扰素α-2b联合拉米夫定治疗慢性乙型肝炎的临床观察

目的 观察干扰素α-2b联合拉米夫定治疗慢性乙型肝炎的抗病毒效果.方法 80例HBsAg、HBeAg、抗HBc阳性、HBV - DNA阳性的患者,随机分为联合组和拉米夫定组,联合组同时给予拉米夫定口服100 mg/d和干扰素α-2 b 5 MU/qod肌肉注射,拉米夫定组为口服拉米夫定100 mg/d,疗程均为12个月.结果 治疗结束时两组患者丙氨酸氨基转移酶、天门冬氨酸氨基转移酶复常,HBV - DNA转阴率类似,但是HBeAg阴转和HBeAg/抗HBe血清转换率,联合组明显高于拉米夫定组.结论 干扰素α-2b联合拉米夫定治疗慢性乙型肝炎疗效优于单用拉米夫定.     

慢性乙型肝炎患者拉米夫定耐药后的后续抗病毒治疗

目的探讨慢性乙型肝炎患者拉米夫定耐药后采用α-干扰素或（和）α1胸腺肽进行后续抗病毒的治疗效果.方法66例拉米夫定耐药患者,分治疗组和对照组.治疗组36例,用α-干扰素或（和）α1胸腺肽治疗1个月后停用拉米夫定,然后继续用α-干扰素或（和）α1胸腺肽治疗,共6个月.对照组30例,直接停用拉米夫定,不用其他抗病毒药.定期进行血清肝功能和病毒学指标检测.结果治疗组肝功能复常率、HBV DNA阴转率和HBeAg/抗-HBe转换率均明显高于对照组,治疗组HBVDNA阴转率最高为27.8%,HBeAg/抗-HBe转换率最高为25.0%.结论慢性乙型肝炎患者拉米夫定耐药后采用α-干扰素或（和）α1胸腺肽进行后续抗病毒治疗是有益的.     

阿德福韦酯联合干扰素治疗HBeAg阳性慢性乙型肝炎成本-疗效分析

目的评价阿德福韦酯联合干扰素治疗HBeAg阳性慢性乙型肝炎所产生的经济效果。方法对本院收治的89例HBeAg阳性慢性乙型肝炎分成2种药物治疗方案,即联合用药组(阿德福韦酯+干扰素)、单用药组(阿德福韦酯)。应用药物经济学观点进行成本-效果比较分析。结果联合用药组和单用药组治疗总有效率为74.47%和42.86%,药品成本-疗效(C/E)为23.14和31.50。结论阿德福韦酯联合干扰素治疗慢性乙型肝炎效果良好,成本-疗效较低,值得在临床上推广。     

拉米夫定和干扰素联合序贯疗法治疗慢性乙型肝炎疗效观察

目的探讨拉米夫定和干扰素联合序贯疗法治疗慢性乙型肝炎（CHB）的疗效.方法 58例CHB患者,随机分为治疗组和对照组.治疗组28例,先用拉米夫定8周,再加用干扰素-α8周,然后停用拉米夫定,单用干扰素-α 16周.对照组30例单用干扰素-α 32周.定期检测肝功能、乙型肝炎病毒DNA.结果全部患者均完成32周治疗.治疗组与对照组抗病毒总有效率分别为71.4%和40.0%,差异具有显著性（P＜0.05）.结论拉米夫定和干扰素-α联合序贯疗法治疗CHB能够提高干扰素-α的抗病毒疗效.     

护理干预对接受α-干扰素治疗患者焦虑、抑郁发生率的影响

目的 探讨降低干扰素所致焦虑、抑郁发生率的有效护理干预措施,使乙型肝炎患者顺利完成干扰素治疗.方法 选择220例接受α-干扰素治疗的乙型肝炎患者,随机分为干预组115例和对照组105例.对照组采用常规护理,干预组在此基础上运用密切观察、心理干预、对症处理等综合干预方法.采用Zung抑郁自评量表比较2组焦虑、抑郁发生率及患者的治疗完成情况.结果 治疗3,6、12个月后,干预组焦虑、抑郁发生率显著低于对照组(P＜0.05).干预组112例完成全程治疗,对照组72例完成全程治疗,全程治疗率干预组显著高于对照组(P＜0.01).结论 密切观察、心理干预、对症处理等护理干预措施可有效降低α-干扰素所致焦虑、抑郁的发生率.     

乙肝病毒YMDD区变异后不同抗病毒疗法效果的系统评价

目的系统评价与拉米夫定相关的乙型肝炎病毒YMDD区变异后不同抗病毒治疗方法的疗效和安全性.方法计算机检索MEDLINE (1989～2004.4)、EMBASE (1989～2004.4)和中国生物医学文献数据库(1989～2004.4);手工检索未发表的中文学术会议文献.收集与拉米夫定相关的乙型肝炎病毒YMDD区变异后不同抗病毒疗法的临床随机与半随机对照试验,由两名评价者独立评价和提取资料,并采用Cochrane协作网专用软件RevMan 4.2进行统计分析.结果共纳入5篇随机和半随机对照研究,包括6个试验组284例病人.Meta分析结果显示,拉米夫定 阿德福韦治疗对HBVDNA、HBeAg转阴率及ALT复常率的效果明显优于单独应用拉米夫定,其RR和95%CI分别为16.61(2.29,120.71),6.66(1.23,35.88)和6.26(2.29,17.12).氧化苦参碱 胸腺肽对HBVDNA、HBeAg转阴率明显优于单独应用拉米夫定,其RR和95%CI分别为2.96(1.26,6.93),2.51(1.05,5.98).试验组单独使用阿德福韦与拉米夫定比较,两者在HBVDNA及HBeAg转阴率方面差异无统计学意义[RR 11.00,95%CI(0.65,186.02);RR 7.00,95%CI(0.39,126.92)];干扰素 拉米夫定对HBVDNA转阴率、HBeAg转阴率、ALT复常率优于单独应用拉米夫定,其RR和95%CI分别为3.50(0.90,13.58),4.90(0.70,35.10)和2.80(0.91,8.12);拉米夫定 中药与拉米夫定比较,其HBVDNA转阴率的差异无统计学意义[RR 1.16,95%CI(0.89,1.51)].在治疗过程中出现的副作用主要有:干扰素组产生流感样症状,阿德福韦组有轻度肾脏损伤,拉米夫定组有少数病例出现一过性病情加重.结论乙肝病毒YMDD变异后,阿德福韦 拉米夫定、氧化苦参碱联合胸腺肽等疗法的抗病毒作用及生化指标改善均优于继续单独使用拉米夫定.但由于样本量偏少,随机对照试验的质量普遍较低,对此尚不能得出肯定性的结论,有待扩大样本进一步研究.     

抗新型冠状病毒感染药物经济学评价的系统评价

目的 系统评价国内外抗新型冠状病毒感染药物的经济评价研究,为临床合理用药提供参考。方法 计算机检索PubMed、Cochrane Library、EMbase、Web of Science、INAHTA、SinoMed、WanFang Data、CNKI数据库,检索时限为2020年1月1日—2023年3月25日,搜集抗新型冠状病毒感染药物经济学评价研究。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,进行描述性分析。结果 共纳入22篇文献,其中11个研究采用卫生体系角度,多数研究的成本类型为直接医疗成本。纳入研究质量评价总体符合率为42%～70%,存在模型设定不全、不确定性分析不全面,缺乏利益相关方参与等不足。研究结果显示免疫治疗药物（地塞米松、托珠单抗）、中和抗体药物（REGEN-COV抗体）、小分子药物（巴瑞替尼、奈玛特韦/利托那韦、莫奈匹韦、法匹拉韦）和他汀类药物治疗新冠患者具有成本-效果,但对瑞德西韦的经济性评价结果存在一定的差异。结论 目前有关抗新型冠状病毒感染药物的经济学评价研究相对较少,但显示新冠防治的多数药物干预措施具有成本-效果。建议未来开展更多规范的、...     

Interpretation of trial-based economic evaluations of musculoskeletal physical therapy interventions

BackgroundAs resources for healthcare are scarce, decision-makers increasingly rely on economic evaluations when making reimbursement decisions about new health technologies, such as drugs, procedures, devices, and equipment. Economic evaluations compare the costs and effects of two or more interventions. Musculoskeletal disorders have a high prevalence and result in high levels of disability and high costs worldwide. Because physical therapy interventions are usually the first line of treatment for musculoskeletal disorders, economic evaluations of such interventions are becoming increasingly important for stakeholders in the field of physical therapy, including physical therapists, decision-makers, and reseachers. However, economic evaluations are relatively difficult to interpret for the majority of stakeholders.ObjectiveTo support physical therapists, decision-makers, and researchers in the field of physical therapy interpreting trial-based economic evaluations and translating the results of such studies to clinical practice.MethodsThe design, analysis, and interpretation of economic evaluations performed alongside randomized controlled trials are discussed. To further illustrate and explain these concepts, we use a case study assessing the cost-effectiveness of exercise therapy compared to standard advice in patients with musculoskeletal disorders.ConclusionsEconomic evaluations are increasingly being used in healthcare decision-making. Therefore, it is of utmost importance that their design, conduct, and analysis are state-of-the-art and that their interpretation is adequate. This masterclass will help physical therapists, decision-makers, and researchers in the field of physical therapy to critically appraise the quality and results of trial-based economic evaluations and to apply the results of such studies to their own clinical practice and setting.     

Lamivudine and interferon versus lamivudine monotherapy for HBeAg-Positive hepatitis B treatment: A meta-analysis of randomized,controlled trials

The suboptimal outcomes of current chronic hepatitis B treatments have prompted the notion of combination therapy as a means of augmenting the therapeutic response. In this study, investigators compared lamivudine monotherapy versus its combination with conventional or pegylated interferon-α, pooling data from all pertinent randomized controlled studies into the meta-analysis. The studies were evaluated for methodologic quality and heterogeneity. Rates of sustained virologic and biochemical responses and of hepatitis B e antigen clearance and seroconversion were used as primary efficacy measures. Quantitative meta-analyses were conducted to assess differences between groups for conventional and pegylated interferon, and overall. Analysis yielded greater sustained virologic, biochemical, and seroconversion rates with the addition of conventional (odds ratio [OR]=4.5, 95% confidence interval [CI]=2.2–9.4,P}<.001; OR=2.1, 95% CI=1.3–3.2,P=.002; and OR=2.6, 95% CI=1.4–4.8,P=.001, respectively) and pegylated (OR=2.0, 95% CI=1.1–3.6,P=.02; OR=1.8, 95% CI=1.3–2.6,P}<.001; and OR=1.6, 95% CI=1.1–2.3,P=.03, respectively) interferon-α to lamivudine, with the former also yielding greater hepatitis B e antigen clearance rates (OR=2.6, 95% CI=1.3–5.2,P=.008). As previous studies suggested that pegylated interferon monotherapy and its combination with lamivudine were comparable, the use of this combination is not justified. In contrast, when conventional interferon-α is used, its combination with lamivudine should be considered.     

Systematic review and quality assessment of economic evaluations and quality-of-life studies related to generalized anxiety disorder

Background: The objectives of this article were to systematically review, summarize the results of, and assess the quality of economic evaluations and humanistic studies related to patients with generalized anxiety disorder (GAD).Methods: EMBASE, EBM Reviews, MEDLINE, and HealthSTAR databases were searched (from the time of inception through April 2008). Full-text publications describing full economic evaluations (cost-benefit, cost-minimization, cost-effectiveness, and cost-utility analyses), partial economic evaluations (cost, burden-of-illness, and resource-utilization analyses), and humanistic outcomes (utilities, preferences, and willingness-to-pay analyses) were included. GAD diagnoses per official publications (eg, Diagnostic and Statistical Manual of Mental Disorders) and associated comorbid conditions were included; anxiety-related symptoms without a diagnosis of GAD were excluded. Study quality was assessed with a 38-point checklist of criteria previously developed by the Panel on Cost-Effectiveness in Health and Medicine.Results: Thirty-six articles were included. Full economic evaluations (n = 5) were based on conventional decision-making modeling or population-summary data, using time horizons ≤12 months. Cognitive-behavioral therapy by a public-salaried psychologist and evidence-based care generated savings compared with current care. Pharmacotherapy with extended-release venlafaxine treatment was cost-effective compared with diazepam; escitalopram was cost-effective compared with paroxetine because of productivity gains. Full economic evaluations addressed 55.3% to 68.4% of the 38 items on the quality-assessment checklist. Partial evaluations were reported; GAD incurred larger mean marginal health care costs compared with other anxiety disorders (a difference of US $2138 in year-1999 values). GAD patients with severe pain interference incurred significantly higher costs than did patients with pain but no GAD. Furthermore, GAD patients used more services from a primary care provider or specialist than did patients with other psychiatric disorders. Comorbidities were associated with greater absenteeism than was having a diagnosis of GAD alone. Mean (SE) utility scores for quality-of-life assessments among patients with GAD (15D, 0.783 [0.019]; EuroQoL EQ-5D, 0.589 [0.038]) were similar to those for patients who were 20 years older and reported somatic conditions such as Parkinson's disease or heart failure.Conclusions: Current evidence suggests that GAD is associated with substantial economic and humanistic impact on patients and health care systems. Future research should address economic evaluations from the private-payer perspective, studies related to the cost of underdiagnosed or untreated GAD, and full economic evaluations that incorporate longer clinical courses of the disorder.     

Interferon-lamivudine combination is no better than lamivudine alone in anti-HBe-positive chronic hepatitis B

BACKGROUND AND AIMS: Results of studies using lamivudine and interferon combination in the treatment of chronic hepatitis B are not consistent or conclusive. This study aimed to evaluate the efficacy of interferon plus lamivudine use versus single lamivudine in anti-HBe-positive chronic hepatitis B. METHODS: Eighty patients were treated with either lamivudine or lamivudine plus simultaneously started interferon. Patients were assigned in groups according to random allocation rule. Lamivudine was given 150 mg/day for 96 weeks in each group; interferon was administered 10 MU three times a week for 24 weeks in the combination therapy group. RESULTS: Alanine aminotransferase (ALT) normalization was achieved earlier in patients treated with lamivudine alone. At the end of treatment, there was no difference between the groups with respect to HBV DNA negativity, ALT normalization and breakthrough rate. Histological improvement was remarkable in each group, but fibrosis score and necro-inflammatory activity were much lower in lamivudine-treated patients. CONCLUSIONS: Addition of interferon to the lamivudine regimen does not increase the effectiveness of the treatment. Considering the side effects of interferon treatment, this combination seems not to be convenient for anti-HBe-positive chronic hepatitis B.     

Economic evaluation of specialist cancer and palliative nursing: a literature review

Little progress has been made in economic evaluation of specialist cancer and palliative care nursing. A literature review of economic studies of clinical nurse specialists (CNSs) was undertaken to assess how the measurement of economic outcomes has been tackled in the literature to date. The initial search found 400 studies. Abstracts from all the studies were reviewed but only 17 studies met the basic criteria for inclusion, reporting primary cost and outcomes data, and clearly specifying the role of a CNS. All of the studies but one focused on direct patient care rather than other CNS roles and were undertaken alongside effectiveness studies. The economic evaluations considered only a narrow range of costs, but a wide range of outcomes. Specific nursing outcomes were only reported in a minority of studies. None of the studies reported cost-effectiveness ratios. However, CNS interventions were reported to be both less costly and more effective than alternative forms of care, negating the need for further cost-effectiveness analysis. Overall, the papers were not of good quality, reducing the validity of the findings. Robust economic evaluations of the CNS role need to be undertaken. These should involve nursing researchers and practitioners so that evaluations reflect the complex and multidimensional nature of CNS care and meet the required standard of evidence to influence practice.     

Square pegs and round holes? A review of economic evaluation in complementary and alternative medicine

INTRODUCTION: Economic evaluation, linking the costs and consequences of an intervention to indicate the potential benefits of alternative interventions, is becoming established as one of the core tools for decision making in health care. As knowledge of the safety and effectiveness of complementary and alternative medicine (CAM) interventions increases, economic evaluation within CAM has a heightened significance. OBJECTIVE: To explore whether the present framework for economic evaluation fits CAM and what modifications if any are needed for its application. Design: Systematic review. METHODS: A comprehensive search of four databases was undertaken (NHS Economic Evaluation Database, AMED, MEDLINE, CINAHL). Studies were included if they took the form of a comparative analysis of costs and consequences of a CAM treatment and were written in English. Each study was reviewed using a set of methodological questions to judge their quality as economic evaluations. RESULTS: A total of 19 studies were identified, of which 9 were cost-effectiveness studies, 7 cost-consequence studies, 2 cost-minimization studies, and 1 cost-benefit analysis. Seventeen (17) of the studies involved CAM treatments being used alongside mainstream or conventional treatments. The majority of the treatments aimed to alleviate pain, including chronic pain, back pain, neck pain, and migraine. Only a small minority of studies addressed wider outcomes of particular relevance to CAM disciplines. Nine (9) adopted a service provider perspective only, 7 included wider sickness absence costs and 3 patient costs. Only 1 study included costs to relatives. The quality of the cost and benefit dimensions of the studies was mixed. CONCLUSIONS: A CAM sensitive approach to economic evaluation is required. This needs to include a focus on outcomes that explore the range of effects of CAM treatment, an exploration of the client's perspective and not just that of the service provider and study designs that facilitate the individualized practitioner approach so central to CAM treatment.     

How to use the results of an economic evaluation.

BACKGROUND: Given the high costs of delivering care to critically ill patients, practitioners and policymakers are beginning to scrutinize the costs and outcomes associated with intensive care. Health economics is a discipline concerned with determining the best way of using resources to maximize the health of the community. This involves addressing questions such as which procedure, test, therapy, or program should be provided, and to whom, given available resources. PURPOSE: The purpose of this article is to review general economic principles that will help intensivists to better interpret published economic evaluations. DATA SOURCES: Selected articles from the health economics and critical care literature. RESULTS: In this article, we use an economic evaluation that examines sedation strategies in critically ill patients. We discuss how learning to critically appraise an economic evaluation is only part of the task for end users. Determining whether and how to apply the results of economic evaluations to local settings presents bigger challenges and remains largely a matter of judgment. CONCLUSIONS: Economic evaluations use analytic techniques to systematically consider all possible costs and consequences of clinical actions. Although they should never form the sole basis for clinical decisions for individual patients, economic evaluations offer potentially useful information at different levels of decision-making.     

拉米夫定胸腺肽a1联用与拉米夫定单用治疗HBeAg阳性慢性乙肝患者的疗效与安全性评价

目的评价拉米夫定＋胸腺肽a1（LAM＋Ta1）与拉米夫定（LAM）单用治疗e抗原阳性慢性乙肝（CHB）患者的疗效与安全性。方法计算机检索CENTRAL、PubMed、CBM、CNKI，均从建库检索至2008年12月，并追踪已获文献的参考文献，纳入LAM＋Ta1与单用LAM的随机对照试验（RCT）。由2名研究者独立进行质量评价及数据提取，采用RevMan5．0软件进行Meta分析。结果共纳入23个RCT，合计1488例患者。Meta分析结果显示，主要结局指标（HBeAg血清转换），在治疗结束时以及停药后随访1年，试验组均优于对照组，其差异有统计学意义[RR（95％CI）分别为2．89（2．40，3．48）和4．99（2．99，8．31）]；次要结局指标（HBV—DNA阴转、HBeAg阴转、ALT复常、HBV—YMDD变异、完全应答、HBsAg阴转），在治疗结束时及停药后随访1年，试验组均优于对照组；与单药治疗组相比，试验组不良反应无明显增加。结论对HBeAg阳性CHB患者，LAM＋Ta，联合疗法可能优于LAM单药疗法；但受纳入文献质量影响，以上结论尚需高质量的临床试验进一步证实。     

Efficacy of alpha interferon therapy for lamivudine resistance in chronic hepatitis B

OBJECTIVES: The occurrence of lamivudine resistance is often associated with the clinical breakthrough, which is characterised by the reappearance of hepatitis B virus (HBV) DNA in serum and the elevation of aminotransferases. We evaluated the efficacy of alpha interferon for clinical breakthrough in patients receiving lamivudine therapy. PATIENTS: Six chronic hepatitis B patients receiving lamivudine were enrolled in the study. RESULTS: Under lamivudine therapy, clinical breakthroughs occurred in between fifteenth and thirty-fourth month of lamivudine therapy. HBV DNA reappeared, and alanine aminotransferase was elevated. Genotypic analysis showed M552V, M552I and L528M mutations. After determining the clinical breakthrough, standard alpha interferon-2b was given for 6 months. Lamivudine was also maintained. In only one patient, HBV DNA became negative by polymerase chain reaction, and serum alanine transaminase level was normal at the end of therapy. CONCLUSION: Alpha interferon added to lamivudine is generally ineffective in the treatment of lamivudine resistance.