Problems in the management of chronic hepatitis B with interferon: experience in a randomized, multicentre study

Area of Science:

• Hepatology
• Virology
• Immunology

Background:

• Chronic hepatitis B (CHB) is a significant global health concern.
• Patients with CHB often have elevated liver enzymes and liver damage.
• Hepatitis B e antigen (HBeAg) and HBV DNA positivity indicate active viral replication.

Purpose of the Study:

• To evaluate the efficacy of recombinant interferon alfa-2a in treating chronic hepatitis B.
• To assess viral clearance, biochemical normalization, and histological improvements.
• To identify predictors of treatment response.

Main Methods:

• A multicentre trial randomized 82 CHB patients to interferon alfa-2a or no treatment.
• Interferon was administered at 4.5 million units thrice weekly for 4 months.
• Follow-up included assessment of viral DNA, HBeAg, and aminotransferase levels.

Main Results:

• Treated patients showed significantly higher rates of HBV DNA clearance and aminotransferase normalization.
• Sustained HBeAg clearance and transaminase normalization were observed at 16 months.
• Improvements in liver inflammation were noted in the interferon group.
• Predictive factors for sustained viral suppression included high baseline aminotransferase levels, female sex, and low fibrosis score.

Conclusions:

• Recombinant interferon alfa-2a is effective in clearing HBV DNA and improving biochemical and histological markers.
• The current treatment regimen leads to significant short-term and medium-term benefits.
• Longer interferon therapy might be necessary for achieving stable suppression of HBV replication.