24 Months of Interferon Found to Improve Survival

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24 Months of Interferon Found to Improve Survival in Some HBV-infected Patients


By Brian Boyle, MD

Hepatitis B virus (HBV) infection is a global problem infecting 350 million people and responsible for 1 million deaths per year. Options for HBV infection remain limited, with 3 drugs approved for HBV treatment including Hepsera (adefovir), Epivir-HBV (lamivudine), and interferon-based therapies.

Still, treatment success remains low and problems with HBV persistence and HBV resistance present significant obstacles to long-term suppression and control of HBV infection and its associated complications.

In a study published in Hepatology, Italian investigators assessed the efficacy of extended treatment with interferon alfa-2b (Intron A) in improving outcomes of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection. The study enrolled 101 consecutive clinic patients in Milan, Italy who were treated with 6 MU of interferon alfa-2b thrice weekly for 24 months.

The study treatment resulted in a sustained response (i.e., normal serum transaminase levels and undetectable hepatitis B virus DNA by non杙olymerase chain reaction [PCR] assays) in 30% of patients and an additional 15 patients successfully cleared serum surface antigen.

Treatment failures included 25 nonresponders, 16 relapsers, and 30 patients who discontinued treatment. A multivariate analysis predicted a sustained virologic response for patents of younger age and with high pre-treatment serum levels of immunoglobulin M (IgM) anti-hepatitis B core antigen (HBcAg).

Notably, none of the sustained responders had progression of Liver disease, while 16 with treatment failure did (0% vs. 22%, p = .002), but hepatocellular carcinoma (HCC) developed with similar frequency in both groups (7%). Overall, the estimated 8-year complication-free survival was longer for the 30 sustained responders than the 71 patients with treatment failure; however 8-year patient survival was similar in the 2 groups. Short-term complication free survival was negatively impacted by a failure to respond to interferon therapy and high scores for liver fibrosis.

The authors conclude, ?4 months of treatment with interferon alfa-2b led to sustained disease suppression in a significant proportion of patients with HBeAg-negative chronic hepatitis B.?/span>

04/11/03

Reference
P Lampertico and others. Long-Term Suppression of Hepatitis B e Antigen Negative Chronic Hepatitis B by 24-Month Interferon Therapy. Hepatology 2003;37:756-763.