Interferon therapy in HBeAg positive chronic hepatitis reduces progression to cirrhosis and hepatocellular carcinoma

• Published in: Journal of hepatology Vol. 46; no. 1; pp. 45 - 52
• Main Authors: Lin, Shi-Ming, Yu, Ming-Lung, Lee, Chuan-Mo, Chien, Rong-Nan, Sheen, I-Shyan, Chu, Chia-Ming, Liaw, Yun-Fan
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.01.2007; Elsevier
• Subjects: Adult; Antiviral Agents - therapeutic use; Biological and medical sciences; Carcinoma, Hepatocellular - prevention & control; Case-Control Studies; Chronic hepatitis B; Cirrhosis; Female; Follow-Up Studies; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Genotype; HBeAg seroconversion; Hepacivirus - genetics; Hepatitis B e Antigens - blood; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - etiology; Hepatocellular carcinoma; Human viral diseases; Humans; Infectious diseases; Interferon; Interferon Type I - therapeutic use; Liver Cirrhosis - prevention & control; Liver Neoplasms - prevention & control; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Other diseases. Semiology; Recombinant Proteins; Tumors; Viral diseases; Viral hepatitis; Cirrhosis; Hepatocellular carcinoma; Interferon; Chronic hepatitis B; HBeAg seroconversion; Prognosis; Cytokine; Hepatic disease; Malignant tumor; Infection; Viral hepatitis B; Viral hepatitis A; Chronic; Treatment; Viral disease; Gastroenterology; Digestive diseases; Evolution; Viral hepatitis E
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2006.08.021

The long-term outcomes of interferon-alpha (IFN-α) therapy in hepatitis B e antigen (HBeAg) seropositive patients remain controversial. This study was conducted to address this issue. The long-term outcomes were compared in 233 IFN-treated patients and 233 well-matched untreated controls. The cumulative incidence at the end of 15 years of follow-up (median 6.8 years, range 1.1–16.5 years) in the IFN-treated patients and controls was: HBeAg seroconversion 74.6% vs. 51.7% ( P = 0.031); hepatitis B surface antigen (HBsAg) seroclearance 3% vs. 0.4% ( P = 0.03); cirrhosis 17.8% vs. 33.7% ( P = 0.041); and hepatocellular carcinoma (HCC) 2.7% vs. 12.5% ( P = 0.011). Significant reduction of HCC was only observed in patients with pre-existing cirrhosis ( P < 0.01). Compared with untreated controls with persistent HBeAg, HBeAg seroconverters in untreated and IFN-treated group showed significantly lower incidence of cirrhosis and HCC ( P = 0.003–0.031), while non-seroconverters of IFN-treated group had marginally significant lower incidence of cirrhosis ( P = 0.065). Multivariate analysis showed that IFN therapy, HBeAg seroconversion and genotype B HBV infection are independent factors for better long-term outcomes. IFN therapy reduces cirrhosis and HCC development.