Treatment of chronic hepatitis B.
Alpha-interferon has emerged as the most effective agent for the treatment of chronic hepatitis when active replication of virus B or D is present. Exogenous administration of human alpha-interferon, now possible through modern large-scale production methods, is associated with disappearance of virus from blood. Amelioration of liver disease occurs in 35% of patients with chronic hepatitis B (e-positive) with interferon doses of 10 MU thrice weekly for 16 weeks; after therapy persistent normalization of serum aminotransferases is observed in 30%. Improvement in liver disease has only occasionally been documented for chronic hepatitis D and for chronic hepatitis B e-minus mutant. Enhanced response rates (> 50%) may possibly be obtained by prolonged intermittent interferon therapy. Combination of interferon with another "antiviral" agent (vidarabine, acyclovir, prednisone) has not increased therapeutic efficacy. Alpha-interferon induces side-effects such as fatigue, flu-like syndrome, myalgia and changes in mood. Patients with decompensated cirrhosis are particularly prone to bacterial infection and disease exacerbation and should receive lower-than-normal doses. Interferon, when applied skillfully, induces the highly beneficial transition of active viral replication into viral latency, thereby greatly reducing infectivity, symptoms and activity of the liver disease.
Schalm
S W
SW
Department of Internal Medicine and Hepatogastroenterology, University Hospital Dijkzigt, Rotterdam, Netherlands.
D000998:Antiviral Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D016527:Drug Costs; D006509:Hepatitis B / Q000097:blood / Q000145:classification / Q000382:microbiology / Q000628:therapy*; D003699:Hepatitis D / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D015337:Multicenter Studies as Topic; D011379:Prognosis; D017735:Virus Latency; D014779:Virus Replication
D000998:Antiviral Agents; D016898:Interferon-alpha