[Interferons as therapy in viral hepatitis: are promises kept?].
Due to their antiviral and immunomodulatory properties, interferons constitute the only efficacious therapy against chronic viral hepatitis. Type-1 interferons are used for therapy with doses ranging between 3 and 10 million units on three days a week. Duration and dose vary with the various forms of viral hepatitis and have not been defined for all instances. In chronic hepatitis B, continued suppression of viral replication can be achieved in 40 to 50% of patients and leads to loss of HBV-DNA and HBe in the serum. 10 to 15% of patients also loose HBs-Ag later on. By carefully selecting patients, even higher success rates can be achieved; however, good selection criteria do not exist for chronic hepatitis C. With this hepatitis, interferons normalize aminotransferases frequently, but sustained elimination of viral infection is still a rare event. Finally, most patients have a relapse of their hepatitis when interferon therapy is terminated. Thus, only 20% of patients with chronic hepatitis C have a sustained benefit from their interferon treatment. Interferon therapy of chronic hepatitis D is even more difficult. Side effects increase with dose and duration of therapy. Fortunately, they only rarely require discontinuation of interferon and are fully reversible, when interferon is stopped. In conclusion, as there exist no therapeutic alternatives, patients with chronic hepatitis B and hepatitis C should be treated with interferon, even though only 20 to 40% of treated patients benefit in the long term.
D000075202:Contraindications; D006509:Hepatitis B / Q000628:therapy; D006526:Hepatitis C / Q000628:therapy; D003699:Hepatitis D / Q000628:therapy; D006521:Hepatitis, Chronic / Q000628:therapy*; D006525:Hepatitis, Viral, Human / Q000628:therapy*; D006801:Humans; D007372:Interferons / Q000009:adverse effects / Q000627:therapeutic use*
D007372:Interferons
Interferone als Therapie der Virushepatitis: Halten sie, was sie versprechen?