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Interferon‐α2b improves short‐term survival in patients transplanted for chronic liver failure caused by hepatitis B
Author(s) -
Hassanein T.,
Colantoni A.,
Maria N. De,
Thiel D.H. Van
Publication year - 1996
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.1996.tb00107.x
Subject(s) - medicine , hbsag , hbeag , immunosuppression , hepatitis b virus , hepatitis b , liver transplantation , transplantation , gastroenterology , immunology , liver disease , hepatitis d virus , cirrhosis , interferon , virology , virus
SUMMARY. Liver transplantation for cirrhosis caused by hepatitis B virus (HBV) has a poor prognosis. This is primarily a consequence of the near universal reinfection of the allograft, subsequent accelerated hepatic disease while receiving immunosuppression, and a reduced long‐term survival. Because interferon‐α has been shown to have an antiviral effect on HBV, a study was initiated in 1986 to assess the effect of interferon‐α therapy on the course of liver transplantation in HBV‐positive recipients. Twenty‐eight patients with decompensated endstage liver disease caused by HBV were treated with 5, 2.5 or 1.25 million units (MU) of human recombinant interferon‐α2b (r‐IFN‐α2b) daily for a minimum of 14 days prior to transplantation and continuing for 42 days post‐transplantation. HBV antigens, HBV antibodies, HBV DNA and serum transaminase levels were measured throughout the treatment and post‐treatment period. HBV DNA was eliminated in 10 of 19 patients, who survived 3 months or more post‐transplantation, and was associated with a significant flare of hepatitis as detected by symptoms and transaminase levels (P < 0.05). Patients who cleared HBV DNA had lower HBV DNA levels (P < 0.05) at entry compared with those who did not. While four of 10 patients with hepatitis B e antigen (HBeAg) converted to hepatitis B e antibody (HBeAb), no surviving patient cleared hepatitis B surface antigen (HBsAg) on a long‐term basis. Nonetheless, post‐transplant survival was significantly better (P < 0.0001, median follow‐up 42 months) in the IFN‐α treated patients as compared with historical controls, and was similar to that of patients transplanted for all causes of parenchymal liver disease other than HBV cancer. Hence IFN‐α therapy in the perioperative liver transplantation period improves short‐term survival but does not prevent HBV infection of the allograft.