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

J Hepatol. 2007 Jan;46(1):45-52. doi: 10.1016/j.jhep.2006.08.021. Epub 2006 Oct 20.

Abstract

Background/aims: The long-term outcomes of interferon-alpha (IFN-alpha) therapy in hepatitis B e antigen (HBeAg) seropositive patients remain controversial. This study was conducted to address this issue.

Methods: The long-term outcomes were compared in 233 IFN-treated patients and 233 well-matched untreated controls.

Results: 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.

Conclusions: IFN therapy reduces cirrhosis and HCC development.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / prevention & control*
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Genotype
  • Hepacivirus / genetics
  • Hepatitis B e Antigens / blood
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / etiology
  • Humans
  • Interferon Type I / therapeutic use*
  • Liver Cirrhosis / prevention & control*
  • Liver Neoplasms / prevention & control*
  • Male
  • Recombinant Proteins

Substances

  • Antiviral Agents
  • Hepatitis B e Antigens
  • Interferon Type I
  • Recombinant Proteins