[Interferons as therapy in viral hepatitis: are promises kept?]

Area of Science:

• Hepatology
• Virology
• Immunology

Background:

• Interferons are the sole effective therapy for chronic viral hepatitis due to their antiviral and immunomodulatory effects.
• Type-1 interferons are administered at 3-10 million units thrice weekly, with variable doses and durations depending on hepatitis type.

Purpose of the Study:

• To evaluate the efficacy and outcomes of interferon therapy in chronic viral hepatitis B, C, and D.
• To determine long-term benefits and limitations of interferon treatment across different hepatitis viral forms.

Main Methods:

• Analysis of patient outcomes based on interferon therapy for chronic viral hepatitis.
• Assessment of viral suppression, serological marker loss, and aminotransferase normalization.
• Evaluation of relapse rates and sustained benefits post-treatment.

Main Results:

• Chronic Hepatitis B: 40-50% achieve viral replication suppression; 10-15% lose HBs-Ag.
• Chronic Hepatitis C: Frequent aminotransferase normalization, but sustained viral elimination is rare (20% long-term benefit); relapse is common.
• Chronic Hepatitis D: Therapy is more challenging; side effects increase with dose/duration but are reversible.

Conclusions:

• Despite variable long-term benefits (20-40%), interferon remains a recommended treatment for chronic Hepatitis B and C due to lack of alternatives.
• Careful patient selection may improve outcomes, but criteria are not well-defined for Hepatitis C.
• Interferon therapy is associated with side effects, though typically reversible upon discontinuation.