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Long‐Term suppression of hepatitis B e antigen‐negative chronic hepatitis B by 24‐month interferon therapy
Author(s) -
Lampertico Pietro,
Del Ninno Ersilio,
Viganò Mauro,
Romeo Raffaella,
Donato Maria Francesca,
Sablon Erwin,
Morabito Alberto,
Colombo Massimo
Publication year - 2003
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1053/jhep.2003.50148
Subject(s) - medicine , gastroenterology , hazard ratio , odds ratio , confidence interval , hbeag , hepatology , interferon alfa , hepatitis b , hepatocellular carcinoma , immunology , hepatitis b virus , alpha interferon , interferon , hbsag , virus
Abstract To assess whether extended treatment with interferon improves the outcome of hepatitis B e antigen (HBeAg)‐negative chronic hepatitis B, 101 consecutive patients were treated with 6 MU of interferon alfa 2b 3 times weekly for 24 months. During the 68‐month study, 30 patients (30%) had a sustained response ( i.e. , normal serum transaminase levels and undetectable hepatitis B virus DNA by non‐polymerase chain reaction [PCR] assays), and 15 cleared serum surface antigen. Twenty‐five nonresponders, 16 relapsers, and 30 who discontinued treatment were considered treatment failures. Multivariate analysis predicted a sustained response for young age (odds ratio, 0.94; 95% confidence interval, 0.89‐0.99; P = .041) and high pretreatment serum levels of immunoglobulin M (IgM) anti‐hepatitis B core antigen (HBc) (odds ratio, 4.52; 95% confidence interval, 1.63‐12.5; P = .004). Liver disease progressed in none of the sustained responders but in 16 with treatment failure (0% vs. 22%, P = .002); hepatocellular carcinoma (HCC) developed with similar frequency in both groups (7%). Overall, estimated 8‐year complication‐free survival was longer for the 30 sustained responders than the 71 patients with treatment failure (90% vs. 60%, P < .001), but 8‐year patient survival was similar in the 2 groups (100% and 90%). Short complication‐free survival was predicted by failure to respond to interferon (hazard ratio, 7.8; 95% confidence interval, 1.8‐34.0; P = .006) and high scores for liver fibrosis (hazard ratio, 1.71; 95% confidence interval, 1.17‐2.50; P = .005). In conclusion, 24 months of treatment with interferon alfa 2b led to sustained disease suppression in a significant proportion of patients with HBeAg‐negative chronic hepatitis B. (Hepatology 2003;37:756‐763.)