Interferon alfa for patients with clinically apparent cirrhosis due to chronic hepatitis B.
BACKGROUND
The prognosis of advanced cirrhosis due to chronic hepatitis B is poor, and results of therapies, including liver transplantation, have been unsatisfactory. Little is known about the effectiveness of interferon alfa in patients with cirrhosis.


METHODS
Between 1984 and 1991, 18 patients with clinically-apparent cirrhosis due to hepatitis B were treated with interferon alfa at the Clinical Center of the National Institutes of Health.


RESULTS
Six treated patients (33%) had a sustained loss of hepatitis B virus DNA and hepatitis B e antigen (if present initially) and decrease of amino-transferase levels into the normal or near normal range. In follow-up, these 6 patients resolved all symptoms of cirrhosis and are alive and fully active. In contrast, the 12 patients who did not have a sustained loss of hepatitis B virus have had evidence of progressive liver disease, 6 have died and 4 underwent hepatic transplantation. Side effects of interferon were common and included bacterial infections (n = 5) and exacerbations of disease (n = 9).


CONCLUSIONS
These findings indicate that interferon alfa is effective in selected patients with mildly decompensated cirrhosis due to hepatitis B.
Hoofnagle
J H
JH
Liver Diseases Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
Di Bisceglie
A M
AM
Waggoner
J G
JG
Park
Y
Y
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001424:Bacterial Infections / Q000209:etiology; D001663:Bilirubin / Q000097:blood; D002908:Chronic Disease; D006509:Hepatitis B / Q000097:blood / Q000150:complications*; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011516:Prothrombin / Q000032:analysis; D011994:Recombinant Proteins; D012709:Serum Albumin / Q000032:analysis
D007370:Interferon Type I; D011994:Recombinant Proteins; D012709:Serum Albumin; D011516:Prothrombin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin