title: Chronic hepatitis B: problem patients (including patients with decompensated disease).
abstract: Most patients with chronic hepatitis B do not respond to a 4-month course of interferon alpha (IFN-alpha) and require alternative therapy. This paper focuses on alternative treatments for patients who are resistant to conventional IFN regimens (primary nonresponders) and those in whom therapy presents a special challenge. Problem patients include healthy hepatitis B surface antigen (HBsAg) carriers and those with minimal serum aminotransferase elevations, immunosuppressed patients, and patients with end-stage liver disease. Special emphasis is given to patients with decompensated liver disease. While dramatic responses to IFN-alpha can occasionally occur in these patients, serious side-effects are common.
authors.affiliation: Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Perrillo
mesh_terms: D002908:Chronic Disease; D004351:Drug Resistance; D006509:Hepatitis B / Q000150:complications / Q000201:enzymology / Q000628:therapy*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016898:Interferon-alpha / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000637:Transaminases / Q000097:blood; D016896:Treatment Outcome
chemical_list: D006514:Hepatitis B Surface Antigens; D016898:Interferon-alpha; D000637:Transaminases