Use of interferon in the treatment of chronic viral hepatitis.
Interferon-alpha therapy has been approved for treatment of chronic hepatitis C and B. Candidates for treatment are patients with well-compensated liver disease and histological evidence of chronic hepatitis who have demonstrated abnormal aminotransferase levels for more than 6 months. In patients with chronic hepatitis B, candidates for treatment need to have evidence of viral replication, either hepatitis B e antigen or hepatitis B virus DNA. Successful response in patients with chronic hepatitis C (i.e., normalization or near-normalization of aminotransferase levels) can be expected to occur in approximately 50% of treated individuals. After a successful course of treatment, the relapse rate is at least 50%. With chronic hepatitis B, successful response (i.e., elimination of viral replicative markers) occurs in approximately 40% of treated patients. In this group, relapse is rare, and successfully treated patients may have no detectable hepatitis B surface antigen with long-term follow-up. Variables that may predict a response in patients with chronic hepatitis C include lower pretherapy alanine aminotransferase levels, female sex, and younger age. In individuals with chronic hepatitis B, response is more likely if pretreatment hepatitis B virus DNA is low, pretherapy alanine aminotransferase levels are high, and the duration of infection is short. Current data available in treating chronic delta hepatitis are limited, but suggest that although transient responses can occur, sustained response is unlikely with this disease.
Gibas
A L
AL
Department of Medicine, University Hospitals of Cleveland, OH 44106.
D002908:Chronic Disease; D002986:Clinical Trials as Topic; D006509:Hepatitis B / Q000628:therapy*; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*
D016898:Interferon-alpha