Experience with Interferon in Chronic Hepatitis B in Egypt

Abstract

Forty patients with compensated chronic active hepatitis B and elevated aminotransferases who were HBsAg and HBeAg positive were randomised to a treatment group receiving recombinant interferon alpha-2b (rIFN alpha-2b) or no treatment as a control group. The treated patients were divided into 2 groups, group I (n = 12) received IFN in a dose of 5 MU/m2 thrice weekly by subcutaneous injection for 16 weeks, and group II (n = 8) received the same dose daily for the same duration. Patients were followed up for 12 months after therapy ended. Initiation of IFN therapy was associated with an increase in aminotransferases, reaching a peak at 4-6 weeks in most patients, associated with clearance of HBeAg. At end of follow-up, 81% of the treated patients had cleared HBeAg vs 33% of the control group (p less than 0.01). Changes in other HBV markers were more frequent in the treated patients, though insignificantly. The type of response to therapy was significantly related to the duration of illness, being shortest in those who cleared HBsAg. A complete response to therapy with loss of HBsAg was associated with marked reduction in biochemical and histological activity. A partial response with clearance of HBeAg was associated with moderate improvement in biochemical parameters and ongoing activity in liver histology; whereas persistence of HBeAg was associated with elevated aminotransferases and histological deterioration in most cases. The rise in aminotransferases during seroconversion was associated with hepatic decompensation and death on 3 occasions: one during spontaneous seroconversion, and the other 2 during IFN therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Meta‐analysis: reduction in hepatic events following interferon‐alfa therapy of chronic hepatitis B

“…The 11 studies included in the final meta‐analysis were published from 1990 to 2007 (Figure 1). 14–17, 28–34 …”

“…Among these 11 studies, three of them were RCTs 32–34 and the remaining were cohort studies 14–17, 28–31 . A total of 2122 patients with a mean age of 41 years were included: 975 patients in the treatment group and 1147 patients in the control group (received no treatment or received placebo) (Table 1).…”

Systematic Review of the Literature on Comparative Effectiveness of Antiviral Treatments for Chronic Hepatitis B Infection

“…Peginterferon alfa-2b combined with lamivudine when compared to lamivudine alone increased HBV DNA clearance and HBsAg seroconversion 95 . All treatments failed to increase rates of post-treatment HBsAg loss at follow up off drug administration (range 8-48 weeks off treatment) 37,43,59,63,67,113,116 .…”

“…Few of the drugs evaluated demonstrated sustained benefits superior to placebo. Interferon alfa-2b improved sustained HBV DNA and HBeAg clearance 40,59,63 , seroconversion 40,59 , and ALT normalization 60,63 . Adefovir improved sustained ALT normalization 75,78 and HBV DNA clearance 75 .…”

Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virus-(HBV-)Infektion: „Upgrade” der Leitlinie, AWMF-Register-Nr.: 021/011

“…Ein virologisches und biochemisches Ansprechen war auch mit einer Verringerung der histologischen Aktivität assoziiert [29,75,119,311,434] (Ia). Komplette Remissionen fibrotischer Veränderungen wurden beobachtet und gehen häufig mit einem HBsAg-Verlust einher [167,203,220,251] (Ib).…”