Long-term clinical remission induced by corticosteroid withdrawal therapy (CSWT) in patients with chronic hepatitis B infection: a prospective randomized controlled trial--CSWT with and without follow-up interferon-alpha therapy.
The effectiveness of corticosteroid withdrawal therapy (CSWT), with or without follow-up interferon-alpha (IFN-alpha), has not been reported for HBe antigen (HBeAg) -positive patients with chronic hepatitis B. We conducted a prospective randomized controlled trial in 42 patients with HBeAg- and HBV-DNA-positive chronic hepatitis B (HBV genotype C: 38 patients) to assess the possible additive effect of follow-up IFN-alpha after CSWT compared with CSWT alone. HBeAg seroconversion rates in the CSWT-alone and the combination group were 11.1% vs 11.8% at 24 weeks, 27.8% vs 12.5% at 52 weeks, 33.3% vs 18.8% at 76 weeks, and 38.9% vs 18.8% at 104 weeks, respectively. The final HBeAg seroconversion rates after CSWT alone were twice those following combination therapy. We conclude that CSWT alone is a very short-term treatment of just three weeks that may be more effective for long-term clinical remission than CSWT followed by IFN-alpha in Japanese genotype C-dominant hepatitis B patients.
Akuta
Norio
N
Division of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Suzuki
Fumitaka
F
Tsubota
Akihito
A
Arase
Yasuji
Y
Suzuki
Yoshiyuki
Y
Someya
Takashi
T
Kobayashi
Masahiro
M
Saitoh
Satoshi
S
Ikeda
Kenji
K
Kumada
Hiromitsu
H
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D000410:Alanine Transaminase