[Alpha-interferon antiviral treatment in 100 patients with chronic hepatitis B].
In a retrospective study we investigated the antiviral effect of alpha-interferon in 100 patients with chronic hepatitis B who were treated in controlled trials conducted in Rotterdam (1985-1990). The aim of the treatment was to induce viral latency as indicated by HBeAg seroconversion. Alpha-interferon was administered in a dose of 5 mega-units per day subcutaneously. Sixty-two patients received alpha-interferon for 16 weeks combined with a second antiviral agent (acyclovir or descyclovir) while the other 38 patients were treated with alpha-interferon monotherapy during 20 to 34 weeks. Follow-up continued until 1 year after the start of therapy. Thirty-eight per cent of the patients exhibited an HBeAg seroconversion and 9% exhibited an HBsAg seroconversion indicating a complete eradication of the virus. After 1 year transaminase levels were normalised in 70% of the patients with HBeAg seroconversion compared with 22% in those without seroconversion (p less than 0.05). The combination therapy for 16 weeks and the alpha-interferon monotherapy of longer duration resulted in HBeAg seroconversion rates of 29% and 53%, respectively (p less than 0.05). The predominant adverse effects were fatigue, flue-like illness and leukopenia. Serious side effects such as seizures, psychosis and peripheral neuropathy occurred in seven patients. Side effects led to a dose reduction in 26% of the patients. Alpha-interferon is effective in terminating the virus replication in chronic hepatitis B. However, both the common mild and the uncommon major side effects necessitate intensive patient monitoring during alpha-interferon treatment.
Janssen
H L
HL
Afd. Inwendige Geneeskunde, Academisch Ziekenhuis Rotterdam-Dijkzigt.
Berk
L
L
de Man
R A
RA
Heijtink
R A
RA
Schalm
S W
SW
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000628:therapy*; D006514:Hepatitis B Surface Antigens / Q000302:isolation & purification; D006513:Hepatitis B e Antigens / Q000302:isolation & purification; D006521:Hepatitis, Chronic / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011355:Prodrugs / Q000627:therapeutic use; D012189:Retrospective Studies
D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D011355:Prodrugs; D000212:Acyclovir
Antivirale behandeling met alpha-interferon bij 100 patiënten met chronische hepatitis B.