Effect of alpha-interferon treatment in patients with hepatitis B e antigen-positive chronic hepatitis B. A meta-analysis

Ann Intern Med. 1993 Aug 15;119(4):312-23. doi: 10.7326/0003-4819-119-4-199308150-00011.


Purpose: To determine whether alpha-interferon is effective in terminating viral replication and in eradicating the carrier state in patients with chronic hepatitis B virus (HBV) infection.

Data sources: Randomized controlled studies published in the English literature between January 1966 and June 1992 were identified through a MEDLINE computer search.

Study selection: Fifteen randomized controlled studies with a total of 837 adult chronic HBV carriers who were positive for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were identified. Studies were included if patients were treated for at least 3 months and followed for at least 6 months after cessation of therapy.

Results: Overall, the loss of HBsAg occurred 6% more often in interferon-treated patients than the natural seroconversion seen in controls (7.8% compared with 1.8%, P = 0.001), and the loss of viral replication occurred approximately 20% more often in treated patients than in controls (33% compared with 12% for loss of HBeAg and 37% compared with 17% for the loss of HBV DNA, P = 0.0001) if patients received interferon for 3 to 6 months and were followed for 6 to 12 months. Interferon also had a significant treatment effect on the development of antibodies to HBsAg (anti-HBs), antibodies to HBeAg (anti-HBe), and on the normalization of alanine aminotransferase levels.

Conclusions: Alpha-interferon is effective in terminating viral replication and in eradicating the carrier state in patients with chronic HBV infection who are HBeAg positive when these patients are treated for 3 to 6 months and followed for 6 to 12 months after cessation of therapy. Follow-up studies are required to determine whether interferon reduces the risk for developing cirrhosis or hepatocellular carcinoma.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carrier State / drug therapy*
  • Carrier State / immunology
  • Chronic Disease
  • DNA, Viral / drug effects
  • Hepatitis B / drug therapy*
  • Hepatitis B / immunology
  • Hepatitis B Surface Antigens / drug effects
  • Hepatitis B e Antigens / drug effects*
  • Hepatitis B virus / drug effects
  • Humans
  • Interferon-alpha / therapeutic use*
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Virus Replication / drug effects
  • Virus Replication / immunology


  • DNA, Viral
  • Hepatitis B Surface Antigens
  • Hepatitis B e Antigens
  • Interferon-alpha