Jules Dienstag, MD

Carl W. Walter Professor of Medicine
Dean for Medical Education
Harvard Medical School

Research Interests:

• Experimental Antiviral Chemotherapy of Chronic Viral Hepatitis
• Hepatitis B: New antiviral agents, including lamivudine and adefovir are being evaluated in patients with compensated, decompensated, and post-liver-transplantation chronic hepatitis B and in patients with lamivudine resistance.
• Hepatitis C: Long-acting interferons (with ribavirin) are being studied both in patients treated for the first time and in nonresponders to previous antiviral therapy. The MGH GI Unit is an investigative site for the NIH-sponsored, multicenter HALT-C (Hepatitis Antiviral Long-term Treatment against Cirrhosis) Trial. This trial is designed to determine whether long-term antiviral therapy can a) prevent progression to cirrhosis in patients with advanced hepatic fibrosis and b) reduce the occurrence of hepatic decompensation and hepatocellular carcinoma and the need for liver transplantation in patients with compensated cirrhosis. Trials are also underway of a novel polymerase inhibitors for the treatment of chronic hepatitis C, both in treatment-naove subjects and previous nonresponders to interferon-based therapies.

Recent Publications:

1. Kuo A, Dienstag JL, Chung RT. Tenofovir disoproxil fumarate for the treatment of lamivudine-resistant hepatitis B. Clinical Gastroenterology and Hepatology 2004; 2:266-272.
   
   
2. Shiffman ML, Di Bisceglie AM, Lindsay, KL, Morishima C, Wright, EC, Everson GT, Lok, AS, Morgan TR, Bonkovsky HL, Lee WM, Dienstag JL, Ghany MG, Goodman ZD, Everhart JE, The HALT-C Trial Group. Peginterferon alfa-2a and ribavirin in patients with chronic hepatitis C who have failed prior treatment. Gastroenterology 2004; 126:1015-1023.
   
   
3. Perrillo RP, Lai C-L, Liaw YF, Dienstag JL, Schiff ER, Schalm SW, Heathcote EJ, Brown NA, Atkins M, Woessner M, Gardner SD. Predictors of HBeAg loss after lamivudine treatment for chronic hepatitis B. Hepatology 2002; 36:186-194.
   
   
4. McHutchison JG, Manns M, Patel K, Poynard T, Lindsay K, Trepo C, Dienstag J, Lee WM, Mak C, Garaud J-J, Albrecht JK, International Hepatitis Interventional Therapy Group. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology 2002; 123:1061-1069.
   
   
5. Dienstag JL, Goldin RD, Heathcote EJ, Hann H-WL, Woessner M, Stephenson SL, Gardner S, Gray DF, Schiff ER. Histological outcome during long-term lamivudine therapy. Gastroenterology 2003; 124:1-13.
   
   
6. Lai C-L, Dienstag J, Schiff E, Leung NWY, Atkins M, Hunt C, Brown N, Woessner M, Boehme R, Condreay L. Prevalence and clinical correlates of YMDD variants during lamivudine therapy of patients with chronic hepatitis B. Clinical Infectious Diseases 2003; 36:687-696.
   
   
7. Dienstag JL, Cianciara J, Karayalcin S, Krowdley KV, Willems B, Plisek S, Woessner M, Gardner S, Schiff E. Durability of response after lamivudine treatment of chronic hepatitis B. Hepatology 2003; 37:748-755.
   
   
8. Schiff ER, Dienstag JL, Karayalcin S, Grimm IS, Perrillo RP, Husa P, de Man RA, Goodman Z, Condreay LD, Crowther LM, Woessner MA, McPhillips PJ, Brown NA, International Lamivudine Investigator Group. Lamivudine and 24 weeks of lamivudine/interferon combination therapy for hepatitis B e antigen-positive chronic hepatitis B in interferon nonresponders. J Hepatology 2003: 38: 818-826.