Long-term effect of interferon therapy in patients with HBeAg positive chronic hepatitis B infection.
BACKGROUND
Several studies have reported that interferon therapy increases elimination rate of HBeAg and anti-HBe seroconversion in chronic hepatitis B (CHB) patients. We aimed to evaluate long-term results of interferon-α treatment in HBeAg positive CHB patients in a country with exclusively D genotype.


METHODS
Seventy-one naive CHB patients (M/F 61/10, mean age 29±12 years, range 16-62) treated with 6 months of interferon-α 2b, 10 MU tiw and had a consequent untreated follow-up period of at least 10 years with positive response were identified and their data were reviewed. The therapy response was defined as HBeAg seroconversion with undetectable HBV-DNA. The responders were followed-up at 3-6-month intervals.


RESULTS
Twenty-eight (39%) patients achieved HBeAg seroconversion (25 within the therapy, 3 within the consequent 12 months off-treatment follow-up). The responders were followed-up with a mean period of 152 months (range 123-181). In the follow-up period, 21/25 (84%) initial responders relapsed. On the other hand, 3 patients who did not respond at the end of therapy sustained the response during follow-up. Hence 21/28 total responders relapsed (75%), either with HBeAg reversion (3, 14.3%) or HBV-DNA elevation over 2000 IU/ml (or its equivalent in other types of definitions) and ALT elevation (18, 85.7%). The sustained response was present in 7 patients (9.8%). Serious side effects precluding completion of treatment occurred in three patients (4.2%). In multivariate analysis none of the pre-treatment parameters appeared to be significant in predicting response.


CONCLUSIONS
Sustained response to interferon treatment is low in HBeAg positive CHB patients with genotype D.
Senturk
Hakan
H
Cerrahpasa Medical Faculty, Department of Gastroenterology, Istanbul University, and Department of Internal Medicine, Istanbul Education and Training Hospital, Istanbul, Turkey. drhakansenturk@yahoo.com
Baysal
Birol
B
Tahan
Veysel
V
Zerdali
Hasan
H
Ozaras
Resat
R
Tabak
Fehmi
F
Mert
Ali
A
Canbakan
Billur
B
Tabak
Omur
O
Ozbay
Gulsen
G
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins
J Clin Virol. 2008 Jun;42(2):160-4
18359663
Am J Gastroenterol. 2006 Feb;101(2):297-303
16454834
Semin Liver Dis. 2006 May;26(2):116-29
16673290
Hepatology. 2004 Mar;39(3):804-10
14999700
Gastroenterology. 1997 Nov;113(5):1660-7
9352870
Hepatology. 2001 Jul;34(1):139-45
11431745
Ann Intern Med. 1991 Apr 15;114(8):629-34
2003708
Clin Infect Dis. 2007 Feb 15;44(4):541-8
17243057
Hepatology. 1997 Nov;26(5):1338-42
9362381
Hepatology. 2002 Jun;35(6):1522-7
12029639
Am J Gastroenterol. 2009 Aug;104(8):1940-6; quiz 1947
19455108
Hepatology. 2007 Aug;46(2):388-94
17604363
Gastroenterology. 2008 Aug;135(2):459-67
18585385
N Engl J Med. 1996 May 30;334(22):1422-7
8618580
Gastroenterology. 2009 Dec;137(6):2002-9
19737568
Am J Gastroenterol. 1999 Aug;94(8):2246-50
10445557
J Hepatol. 2009 Feb;50(2):227-42
19054588
World J Gastroenterol. 2005 Apr 7;11(13):1976-80
15800989
Hepatology. 1981 Sep-Oct;1(5):431-5
7308988
Clin Infect Dis. 2008 Nov 15;47(10):1305-11
18840078