Interferon therapy in HBeAg positive chronic hepatitis reduces progression to cirrhosis and hepatocellular carcinoma.
OBJECTIVE
The long-term outcomes of interferon-alpha (IFN-alpha) therapy in hepatitis B e antigen (HBeAg) seropositive patients remain controversial. This study was conducted to address this issue.


METHODS
The long-term outcomes were compared in 233 IFN-treated patients and 233 well-matched untreated controls.


RESULTS
The cumulative incidence at the end of 15 years of follow-up (median 6.8 years, range 1.1-16.5 years) in the IFN-treated patients and controls was: HBeAg seroconversion 74.6% vs. 51.7% (P=0.031); hepatitis B surface antigen (HBsAg) seroclearance 3% vs. 0.4% (P=0.03); cirrhosis 17.8% vs. 33.7% (P=0.041); and hepatocellular carcinoma (HCC) 2.7% vs. 12.5% (P=0.011). Significant reduction of HCC was only observed in patients with pre-existing cirrhosis (P<0.01). Compared with untreated controls with persistent HBeAg, HBeAg seroconverters in untreated and IFN-treated group showed significantly lower incidence of cirrhosis and HCC (P=0.003-0.031), while non-seroconverters of IFN-treated group had marginally significant lower incidence of cirrhosis (P=0.065). Multivariate analysis showed that IFN therapy, HBeAg seroconversion and genotype B HBV infection are independent factors for better long-term outcomes.


CONCLUSIONS
IFN therapy reduces cirrhosis and HCC development.
Lin
Shi-Ming
SM
Liver Research Unit, Chang Gung University and Chang Gung Memorial Hospital, Taipei, Taiwan.
Yu
Ming-Lung
ML
Lee
Chuan-Mo
CM
Chien
Rong-Nan
RN
Sheen
I-Shyan
IS
Chu
Chia-Ming
CM
Liaw
Yun-Fan
YF
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000517:prevention & control*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000517:prevention & control*; D008113:Liver Neoplasms / Q000517:prevention & control*; D008297:Male; D011994:Recombinant Proteins
D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D007370:Interferon Type I; D011994:Recombinant Proteins