Natural course and response to interferon of chronic hepatitis B accompanied by antibody to hepatitis B e antigen.
The course of chronic hepatitis B was studied in 30 patients who had antibody to hepatitis e antigen and hepatitis B virus DNA in the serum and hepatitis B core antigen in the liver. Over a 2-year period, no patient experienced a sustained spontaneous remission of disease, and follow-up liver histology revealed worsening of the disease in four patients. After 2 years of observation, 24 patients were allocated randomly to one of two groups: 12 patients served as untreated controls and 12 received recombinant human alpha-interferon-2a in a dose of 9 million units intramuscularly three times weekly for 16 weeks. Patients who remained viremic after 16 weeks received 3 million units three times weekly for an additional 8 weeks. Abnormal amino-transferases and serum hepatitis B virus DNA persisted without appreciable changes in all untreated patients. Hepatitis B virus DNA rapidly became undetectable and serum aminotransferases fell to normal in eight treated patients. After the end of treatment, hepatitis B virus DNA became detectable once again in seven patients, in six of whom a peak of aminotransferases (range: 256 to 850 units per liter) ensued; subsequently, hepatitis B virus DNA disappeared, and serum aminotransferases again fell to normal in two of the seven. Overall, hepatitis B virus DNA was no longer detectable in serum and liver histology improved in three treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Brunetto
M R
MR
Department of Gastroenterology, San Giovanni Battista Molinette Hospital, Turin, Italy.
Oliveri
F
F
Rocca
G
G
Criscuolo
D
D
Chiaberge
E
E
Capalbo
M
M
David
E
E
Verme
G
G
Bonino
F
F
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000201:enzymology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007370:Interferon Type I / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011897:Random Allocation
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; D007075:Immunoglobulin M; D007370:Interferon Type I; D000410:Alanine Transaminase