Effect of alpha-interferon treatment in patients with hepatitis B e antigen-positive chronic hepatitis B. A meta-analysis.
OBJECTIVE
To determine whether alpha-interferon is effective in terminating viral replication and in eradicating the carrier state in patients with chronic hepatitis B virus (HBV) infection.


METHODS
Randomized controlled studies published in the English literature between January 1966 and June 1992 were identified through a MEDLINE computer search.


METHODS
Fifteen randomized controlled studies with a total of 837 adult chronic HBV carriers who were positive for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were identified. Studies were included if patients were treated for at least 3 months and followed for at least 6 months after cessation of therapy.


RESULTS
Overall, the loss of HBsAg occurred 6% more often in interferon-treated patients than the natural seroconversion seen in controls (7.8% compared with 1.8%, P = 0.001), and the loss of viral replication occurred approximately 20% more often in treated patients than in controls (33% compared with 12% for loss of HBeAg and 37% compared with 17% for the loss of HBV DNA, P = 0.0001) if patients received interferon for 3 to 6 months and were followed for 6 to 12 months. Interferon also had a significant treatment effect on the development of antibodies to HBsAg (anti-HBs), antibodies to HBeAg (anti-HBe), and on the normalization of alanine aminotransferase levels.


CONCLUSIONS
Alpha-interferon is effective in terminating viral replication and in eradicating the carrier state in patients with chronic HBV infection who are HBeAg positive when these patients are treated for 3 to 6 months and followed for 6 to 12 months after cessation of therapy. Follow-up studies are required to determine whether interferon reduces the risk for developing cirrhosis or hepatocellular carcinoma.
Wong
D K
DK
Toronto Hospital, Ontario.
Cheung
A M
AM
O'Rourke
K
K
Naylor
C D
CD
Detsky
A S
AS
Heathcote
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002353:Carrier State / Q000188:drug therapy* / Q000276:immunology; D002908:Chronic Disease; D004279:DNA, Viral / Q000187:drug effects; D006509:Hepatitis B / Q000188:drug therapy* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000187:drug effects; D006513:Hepatitis B e Antigens / Q000187:drug effects*; D006515:Hepatitis B virus / Q000187:drug effects; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014779:Virus Replication / Q000187:drug effects / Q000276:immunology
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha