13. Should the e-antigen be used to determine the success/end point of treatment?
If you actually look at a lot of the Asian
patients who have been infected a long time, they are already
e-antibody positive and e-antigen
negative, and their DNA level could still be very
high. When I was on the FDA committee for the
lamivudine approval hearing, I raised this point. For those with long-term
chronic infection, using the e-antibody seroconversion may not be the
best way to determine the endpoint of treatment, because a lot of
people will already have this conversion, and they are still at high
risk for liver cancer. For those with a recent infection, the
seroconversion as endpoint works better. I think that in general, using the e-antigen
conversion to assess the endpoint of treatment should be
12. What are the guidelines for evaluating treatment among chronic carriers with elevated ALTs (liver enzyme levels)?
14. How do you determine which treatment should be used, and for how long?