Abstract
Interferon alpha is the only available therapy for patients with chronic hepatitis B. With interferon alpha 3–15 MU thrice weekly or 5 MU daily during 3–6 months one-third of the patients achieve seroconversion of HBeAg and HBV-DNA together with normalization of aminotransferases and slight improvement of histology. Loss of HBsAg is reported in a minority of responders during treatment, but increases during follow-up. Patients with baseline alanine aminotransferase of at least twice the upper limit of normal and low HBV-DNA concentration achieve the best response rates. HIV-positive patients with low CD4 counts and Asians are poor responders. As side-effects influenza-like symptoms are experienced by almost all patients. Mild leukopenia, thrombocytopenia and decreased hairgrowth are frequently reported. Severe depression, depersonalization and psychosis are reported in a small number of patients but tend to be poorly recognized in some studies. The decision whether dose reduction is indicated seems strongly related to the opinion of the investigator. Although long-term effects on the occurrence of cirrhosis and the development of hepatocellular carcinoma are not available yet, the achieved results are promising.
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References
Hoofnagle JH. Chronic hepatitis B. N Engl J Med 1990;323:337–9.
Cecil RL. Textbook of medicine. 18th ed. Philadelphia: WB Saunders, 1988:821–3.
Sherlock S. Diseases of the liver and biliary system. 8th ed. Oxford: Blackwell Scientific Publications, 1989:339–41 356, 262–3.
Hoofnagle JH. Chronic type B hepatitis. Gastroenterology 1983;84:422–4.
Hoofnagle JH, Shafritz DA, Popper H. Chronic type B hepatitis and the healthy carrier state. Hepatology 1987;7:758–63.
Brunetto MR, Oliveri F, Rocca G, Criscuolo D, Chiaberge E, Capalbo M, et al. Natural course and response to interferon of chronic hepatitis B accompanied by antibody to hepatitis B e antigen. Hepatology 1989;10:198–202.
Kassianides C, DiBisceglie AM, Hoofnagle JH, Mullen K, Peters M, Rustgi V, et al. Alpha-interferon therapy in patients with decompensated chronic type B hepatitis. In: Zuckerman AJ, ed. Viral hepatitis and liver disease. New York: Alan R. Liss, 1988:840–3.
Balkwill F. Interferons. Lancet 1989;1:1060–3.
Davis GL, Hoofnagle JH. Interferon in viral hepatitis. Role in pathogenesis and treatment. Hepatology 1986;6:1038.
Greenberg HB, Pollard RB, Lutwick LI, Gregory PB, Robinson WS, Merigan TC. Effect of human leucocyte interferon on hepatitis B virus infection in patients with chronic active hepatitis. N Engl J Med 1976;295:517–22.
Wills R. Clinical Pharmacokinetics of interferons. Clin Pharmacokinet 1990;19:390–9.
Wills RJ, Dennis S, Spiegel HE, Gibson DM, Nadler PI. Interferon kinetics and adverse reactions after intravenous, intramuscular and subcutaneous injections. Clin Pharmacol Ther 1984;35:722–7.
Gutterman JU, Fine S, Quesada J, Horning SJ, Levine JF, Alexanian R, et al. Recombinant leucocyte interferon: pharmacokinetics, single-dose tolerance and biologic effects in cancer patients. Ann Intern Med 1982;96:549–56.
Omata M, Imazeki F, Yokosuka O, Ito Y, Uchiumi K, Mori J, et al. Recombinant leukocyte A interferon. Treatment in patients with chronic hepatitis B virus infection. Gastroenterology 1985;88:870–80.
Dooly JS, Davis GL, Peters M, Waggoner JG, Goodman Z, Hoofnagle JH. Pilot study of recombinant human alpha interferon for chronic type B hepatitis. Gastroenterology 1986;90:150–7.
Smit CI, Weisenberg J, Berkardt L, Gregory PB, Robinson WS, Merigan TC. Acute Dane particle suppression with recombinant leucocyte interferon in chronic hepatitis B virus infection. J Infect Dis 1983;148:907–13.
Saracco G, Mazzella G, Rosina F, Cancellieri C, Lattore V, Raise E, et al. A controlled trial of lymphoblastoid interferon in chronic hepatitis B in Italy. Hepatology 1989;10:336–41.
Perillo R. Treatment of chronic hepatitis B with interferon. Experience in western countries. Semin Liver Dis 1989;9:240–8.
Rakela J, Wood JR, Czaja AJ, O'Brien PC, Bowyer BA, Lange SM, et al. Long-term versus short-term treatment with recombinant interferon alpha-2a in patients with chronic hepatitis B: a prospective, randomized treatment trial. Mayo Clin Proc 1990;65:1330–5.
Schalm SW, Heijtink RA. Spontaneous disappearance of viral replication and liver cell inflammation in HBsAg-positive chronic active hepatitis. Results of a placebo vs. interferon trial. Hepatology 1982;2:791–4.
Dusheiko G, DiBisceglie A, Bowyer S, Sachs E, Ritchie M, Schoub B, et al. Recombinant leucocyte interferon treatment of chronic hepatitis B. Hepatology 1985;5:556–60.
Perillo RP, Schiff ER, Davis GL, Bodenheimer HC, Lindsay K, Payne J, et al. A randomized trial of interferon alpha-2b alone and after prednisone withdrawal for the treatment of chronic hepatitis B. N Engl J Med 1990;323:295–301.
Brook MG, McDonald JA, Karayiannis P, Caruso L, Forster G, Harris JRW, et al. Randomized controlled trial of interferon alpha 2a for the treatment of chronic hepatitis B virus infection: factors that influence response. Gut 1989;30:116–22.
Müller R, Baumgarten R, Markus M, Schulz M, Wittenberg H, Hintsche-Kilger B, et al. Behandlung der chronischen Hepatitis B mit Interferon alpha-2b. Dtsch Med Wochenschr 1990;115:403–7.
Korenman J, Baker B, Waggoner J, Everhart JE, DiBisceglie AM, Hoofnagle JH, Long-term remission of chronic hepatitis B after alpha-interferon therapy. Ann Intern Med 1991;114:629–34.
Perillo RP, Regenstein FG, Peters MG, DeSchryver-Kecskemeti K, Bodicky CJ, Campbell CR, et al. Prednisone withdrawal followed by recombinant alpha interferon in the treatment of chronic type B hepatitis. Ann Intern Med 1988;109:95–100.
Brook MG, Chan G, Yap I, Karayianis P, Lever AML, Jacyna M, et al. Randomized controlled trial of lymphoblastoid interferon alpha in Europid men with chronic hepatitis B virus infection. BMJ 1989;299:652–6.
Alexander GJM, Fagan EA, Daniels HM, Brahm J, Smith HM, Eddleston ALWF, et al. Loss of HBsAg with interferon therapy in chronic hepatitis B virus infection. Lancet 1987;2:66–8.
Lai C-L, Lin H-J, Yeoh E-K, Fong Lok AS, Wu PC, Yung Yeung C. Placebo controlled trial of recombinant alpha 2-interferon in Chinese HBsAg carrier children. Lancet 1987;2:877–80.
Lok ASF, Lai CL, Wu PC, Leung EKY. A randomized controlled trial of recombinant alpha interferon in Chinese patients with chronic hepatitis B virus infection: an interim report. In: Zuckerman AJ, ed. Viral hepatitis and liver disease. New York: Alan R. Liss, 1988:848–9.
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Braken, J.B., Koopmans, P.P., Van Munster, I.P. et al. Current status of interferon alpha in the treatment of chronic hepatitis B. Pharmaceutisch Weekblad Scientific Edition 14, 167–173 (1992). https://doi.org/10.1007/BF01962533
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DOI: https://doi.org/10.1007/BF01962533