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Efficacy of long-term interferon therapy in chronic hepatitis B patients with HBV genotype C
Takahisa Sakai1, Katsuya Shiraki, Hidekazu Inoue
1First Department of Internal Medicine, Mie University School of Medicine, Tsu, Mie 514-8507, Japan.
Insights
Long-term interferon therapy shows greater efficacy in treating Hepatitis B virus (HBV) genotype C infections in Japanese patients. Female patients and those receiving extended treatment demonstrated higher rates of Hepatitis B e antigen (HBeAg) seroconversion.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Hepatitis B virus (HBV) genotype C is prevalent in Japan.
- Chronic HBV infection requires effective treatment strategies.
- Interferon (IFN) therapy is a common treatment modality.
Purpose of the Study:
- To evaluate the efficacy of interferon (IFN) therapy in Japanese patients with chronic Hepatitis B virus (HBV) genotype C infection.
- To identify clinical predictors of therapeutic response to IFN treatment.
- To compare the outcomes of short-term versus long-term IFN therapy.
Main Methods:
- Retrospective study of 43 HBeAg-positive chronic HBV genotype C patients treated with IFN.
- Patients were divided into short-term (4 weeks) and long-term (24 weeks) IFN therapy groups.
- Multivariate analysis (Cox proportional hazard models) and Kaplan-Meier survival analysis were used to assess predictors of response.
Main Results:
- Long-term IFN therapy resulted in higher rates of normalized serum ALT and HBeAg seroconversion (38%) compared to short-term therapy (15%), though not statistically significant (p=0.137).
- IFN treatment group and female sex were identified as independent significant factors predicting therapeutic efficacy (p<0.05).
- Cumulative HBeAg seroconversion rates were significantly higher in females (p=0.015) and in the long-term IFN therapy group (p=0.0046).
Conclusions:
- Long-term interferon therapy appears more effective than short-term therapy for chronic HBV genotype C infection in Japanese patients.
- Female sex and longer duration of IFN treatment are associated with better treatment outcomes, including HBeAg seroconversion.
- Further prospective studies may be warranted to confirm these findings and optimize IFN treatment protocols for HBV genotype C.
Abstract:
Infection with Hepatitis B virus (HBV) genotype C predominates in Japan. We analyzed the efficacy of interferon (IFN) alpha or beta in the treatment of chronic hepatitis B patients with HBV genotype C and the clinical predictors for therapeutic response. Forty-three genotype C-infected, chronic hepatitis B e antigen (HBeAg)-positive patients (32 men and 11 women with a mean age of 35.6+/-10.1 years) who had been treated with IFN therapy were retrospectively studied. The patients were classified into two treatment groups. Short-term therapy group was administered a 5-6 MU dose three times weekly for 4 weeks, and the long-term therapy group for 24 weeks. At the end of the follow-up period, 4 (15%) of 27 short-term therapy group patients and 6 (38%) of 16 long-term therapy group patients had normalized serum ALT levels and seroconversion of HBeAg to anti-HBe (p=0.137). Multivariate analysis for parameters most important for the efficacy of IFN therapy was performed using Cox proportional hazard models in order to investigate the association between baseline characteristics of patients and the response to IFN treatment. As a result, the p-values of IFN treatment group and sex were <0.05, and both factors can be recognized as independent significant factors (relative risk, 2.93 and 2.53; p=0.027 and 0.040, respectively). Furthermore, the cumulative rates of seroconversion of HBeAg to anti-HBe analyzed by the Kaplan-Meier method was significantly higher in the female group (p=0.015) and in the long-term IFN therapy group (p=0.0046). In summary, long-term IFN therapy may be more effective than short-term IFN therapy for patients with chronic HBV genotype C infection.