Activation of liver disease in healthy hepatitis B surface antigen carriers during interferon-alpha treatment.
Fifty percent of healthy hepatitis B surface antigen carriers may have histologically proven chronic hepatitis. Our aim was to study the benefit of interferon-alpha in healthy patients. Twenty-nine hepatitis B surface antigen carriers with normal liver enzymes and with serum hepatitis B virus DNA were randomized into two groups: Group I, 14 patients treated with 9 megaunits of interferon alpha-2a thrice weekly for six months, and Group II, 15 control patients. A liver biopsy was obtained from each patient at study initiation. A second biopsy was available in nine treated patients and six controls. During treatment, a significant increase in alanine amino transferase levels was observed in treated patients as compared with the controls (P < 0.05). After treatment, transaminase levels decreased to normal values. No differences between treated and control patients were observed in clearance of hepatitis B virus markers. A significant increase in the total histological activity index between base line and final liver biopsies was observed in treated patients (P < 0.05). It is concluded that interferon alpha treatment may induce a biochemical and histological activation of liver disease. Accordingly, interferon alpha should not be administered to healthy hepatitis B surface antigen carriers, at least with the schedule used in this work.
Rodríguez-Iñigo
E
E
Department of Hepatology, Fundación Jiménez Díaz, Madrid, Spain.
Bartolomé
J
J
López-Alcorocho
J M
JM
Contonat
T
T
Oliva
H
H
Carreño
V
V
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D002353:Carrier State / Q000201:enzymology / Q000473:pathology / Q000628:therapy*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000201:enzymology / Q000473:pathology / Q000628:therapy*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D006521:Hepatitis, Chronic / Q000201:enzymology / Q000473:pathology / Q000628:therapy; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008099:Liver / Q000201:enzymology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D000410:Alanine Transaminase