The long-term outcome of interferon-alpha treated and untreated patients with HBeAg-negative chronic hepatitis B.
OBJECTIVE
This study aimed to evaluate the effect of interferon-alpha therapy on the long-term outcome of HBeAg-negative chronic hepatitis B.


METHODS
A cohort of 209 interferon-alpha treated and 195 untreated patients with histologically documented HBeAg-negative chronic hepatitis B were closely followed for a mean of 6 (1-13.5) years. Patients with decompensated liver disease and/or hepatocellular carcinoma at presentation were excluded.


RESULTS
Survival and complication (liver decompensation and/or hepatocellular carcinoma) -free survival were significantly worse in patients with compared to those without baseline cirrhosis and in patients older compared to those younger than 45 years (P < 10(-4)). Sustained biochemical remission was achieved in 57 treated patients. Sustained responders had significantly better survival and complication-free survival than non-sustained responders (P = 0.027 and P = 0.019, respectively) or than untreated patients (P = 0.048 and P = 0.012, respectively). Multivariate analysis showed that absence of baseline cirrhosis, younger age, and sustained biochemical remission were independently associated with an improved outcome.


CONCLUSIONS
In patients with HBeAg-negative chronic hepatitis B, sustained biochemical remission induced by interferon-alpha is associated with improved long-term outcome, even in the presence of cirrhosis and old age, both known factors associated with worse survival. Therefore, long-term biochemical remission appears to represent a satisfactory therapeutic target in this setting.
Academic Department of Medicine, Hippokration General Hospital, Athens, Greece.
G V
GV
Papatheodoridis
E
E
Manesis
S J
SJ
Hadziyannis
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D015996:Survival Rate
D006513:Hepatitis B e Antigens; D007370:Interferon Type I; D011994:Recombinant Proteins