Anti-HBV vaccination before therapy with interferon (IFN) in chronic B hepatitis

Thirty-five outpatients (7 F, 28 M, mean age 39.8 years) with histologically confirmed active chronic B hepatitis, have been immunised with specific anti-HBV vaccine (Engerix B 20 mcg, SmithKline Beecham Biologicals, Rioxensart, Belgium) on days 0, 30 and 60. Hepatitis B markers, HBV-DNA and anti-HDV antibodies were determined on the same day of vaccination. One week after the last dose of anti-HBV vaccine, 15 and 10 patients have been treated respectively with alpha-leukocyte-IFN and beta-natural-IFN at the dose of 6 mU three times/week for one year; the remaining 10 patients were included in the control group. Hepatitis B and D markers and transaminases were monitored monthly during IFN therapy. Within one month from the last dose of anti-HBV vaccine, 20 patients out 35 have shown a transitory disappearance of HBV-DNA. After the 2nd dose in 4 patients a marked increase in AST and ALT levels was observed (up to 10 times the normal values). After the 3rd dose (last dose) five HBV-DNA-negative patients have shown transitory low levels of anti-HBs antibodies; moreover, after the last dose of anti-HBV, one HBV-DNA-negative patient resulted HBV-DNA-positive. After one year of IFN-therapy, 8 patients out 15 treated with alpha-leukocyte-IFN and 2 treated with beta-natural-IFN, have shown normalisation of transaminases. These results confirm the effectiveness of an anti-HBV vaccination before an IFN treatment and a better response achieved with alpha-leukocyte-IFN.