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Erschienen in: Digestive Diseases and Sciences 3/2007

01.03.2007 | Original Article

Long-Term Results of Interferon Alpha Monotherapy in Patients with HBeAg-Negative Chronic Hepatitis B

verfasst von: Sabahattin Kaymakoglu, Ahmet Danalioglu, Kadir Demir, Cetin Karaca, Filiz Akyuz, Derya Onel, Selim Badur, Ugur Cevikbas, Fatih Besisik, Yilmaz Cakaloglu, Atilla Okten

Erschienen in: Digestive Diseases and Sciences | Ausgabe 3/2007

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Abstract

We sought to evaluate the long-term results of interferon-α (IFN-α) therapy in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B. Eighty HBeAg-negative naive patients (62 men; mean age, 39.9 years) who received IFN-α for 6 months were studied. Alanine aminotransferase normalization with undetectable HBV-DNA by molecular hybridization was accepted as response. All patients but 1 were precirrhotic stage. At the end of treatment, 44 (55%) patients responded, and they were followed for a mean of 59.5 months (range, 18–132). Twenty-seven patients (61.4%) showed recurrence (63% in first year). Responses at 6 months and at the end of the follow-up period 42.5% and 30% (including 7 patients without end treatment response), respectively. Recurrence of HBV replication was not detected after the 2-years follow-up period. Histologic improvement was observed in 83.3% patients with end-of-follow-up response. HBsAg became negative in 4 patients (5%). On multivariate analysis, younger age (P=.04) and lower GGT level (P=.037) were independent factors for prediction of end-of-follow-up response. Nearly half of the patients with HBeAg-negative chronic hepatitis B responds to IFN-α at the end of therapy. Despite the high recurrence rates, response continues in about one third of patients after a mean of 59.5 months.
Literatur
1.
Zurück zum Zitat Maynard JE (1990) Hepatitis B: global importance and need for control. Vaccine 8(suppl):S18–S20PubMedCrossRef Maynard JE (1990) Hepatitis B: global importance and need for control. Vaccine 8(suppl):S18–S20PubMedCrossRef
2.
Zurück zum Zitat Margolis HS, Alter MJ, Hadler SC. Hepatitis B (1991) evolving epidemiology and implications for control. Semin Liver Dis 11:84–92PubMedCrossRef Margolis HS, Alter MJ, Hadler SC. Hepatitis B (1991) evolving epidemiology and implications for control. Semin Liver Dis 11:84–92PubMedCrossRef
3.
Zurück zum Zitat Schalm SW, Thomas HC, Hadziyannis SJ (1990) Chronic hepatitis B. In: Popper H, Schaffner F, eds. Progress in Liver Disease. New York: W.B. Saunders; 443–462 Schalm SW, Thomas HC, Hadziyannis SJ (1990) Chronic hepatitis B. In: Popper H, Schaffner F, eds. Progress in Liver Disease. New York: W.B. Saunders; 443–462
4.
Zurück zum Zitat Lok AS, Heathcote EJ, Hoofnagle JH (2001) Management of hepatitis B: 2000—summary of a workshop. Gastroenterology 120:1828–1853PubMed Lok AS, Heathcote EJ, Hoofnagle JH (2001) Management of hepatitis B: 2000—summary of a workshop. Gastroenterology 120:1828–1853PubMed
5.
Zurück zum Zitat Santantonio T, Mazzola M, Iacovazzi T, Miglietta A, Guastadisegni A, Pastore G (2000) Long-term follow-up of patients with anti-HBe/HBV DNA-positive chronic hepatitis B treated for 12 months with lamivudine. J Hepatol 32:300–306PubMedCrossRef Santantonio T, Mazzola M, Iacovazzi T, Miglietta A, Guastadisegni A, Pastore G (2000) Long-term follow-up of patients with anti-HBe/HBV DNA-positive chronic hepatitis B treated for 12 months with lamivudine. J Hepatol 32:300–306PubMedCrossRef
6.
Zurück zum Zitat Tassopoulos NC, Volpes R, Pastore G, Heathcote J, Buti M, Goldin RD, et al (1999) Efficacy of lamivudine in patients with hepatitis B e antigen-negative/hepatitis B virus DNA-positive (precore mutant) chronic hepatitis B. Lamivudine Precore Mutant Study Group. Hepatology 29:889–896PubMedCrossRef Tassopoulos NC, Volpes R, Pastore G, Heathcote J, Buti M, Goldin RD, et al (1999) Efficacy of lamivudine in patients with hepatitis B e antigen-negative/hepatitis B virus DNA-positive (precore mutant) chronic hepatitis B. Lamivudine Precore Mutant Study Group. Hepatology 29:889–896PubMedCrossRef
7.
Zurück zum Zitat Carman WF, Jacyna MR, Hadziyannis S, McGarvey M, Karayiannis P, Thomas HC (1989) Mutation preventing formation of 'hepatitis B e antigen' in patients with chronic hepatitis B infection. Lancet ii:588–590CrossRef Carman WF, Jacyna MR, Hadziyannis S, McGarvey M, Karayiannis P, Thomas HC (1989) Mutation preventing formation of 'hepatitis B e antigen' in patients with chronic hepatitis B infection. Lancet ii:588–590CrossRef
8.
Zurück zum Zitat Laras A, Koskinas J, Avgidis K, Hadziyannis SJ (1998) Incidence and clinical significance of hepatitis B virus precore gene translation initiation mutations in e antigen-negative patients. J Viral Hep 5:241–248CrossRef Laras A, Koskinas J, Avgidis K, Hadziyannis SJ (1998) Incidence and clinical significance of hepatitis B virus precore gene translation initiation mutations in e antigen-negative patients. J Viral Hep 5:241–248CrossRef
9.
Zurück zum Zitat Lindh M, Horal P, Dhillon AP, Furuta Y, Norkrans G (1996) Hepatitis B virus carriers without precore mutations in hepatitis B e antigen-negative stage show more severe liver damage. Hepatology 24:494–501PubMedCrossRef Lindh M, Horal P, Dhillon AP, Furuta Y, Norkrans G (1996) Hepatitis B virus carriers without precore mutations in hepatitis B e antigen-negative stage show more severe liver damage. Hepatology 24:494–501PubMedCrossRef
10.
Zurück zum Zitat Chan HL, Leung NW, Hussain M, Wong ML, Lok AS (2000) Hepatitis B e antigen-negative chronic hepatitis B in Hong Kong. Hepatology 31:763–768PubMedCrossRef Chan HL, Leung NW, Hussain M, Wong ML, Lok AS (2000) Hepatitis B e antigen-negative chronic hepatitis B in Hong Kong. Hepatology 31:763–768PubMedCrossRef
11.
Zurück zum Zitat Greenberg HB, Pollard RB, Lutwick LI, Gregory PB, Robinson WS, Merigan TC (1976) Effect of human leukocyte interferon on hepatitis B virus infection in patients with chronic active hepatitis. N Engl J Med 295:517–522PubMedCrossRef Greenberg HB, Pollard RB, Lutwick LI, Gregory PB, Robinson WS, Merigan TC (1976) Effect of human leukocyte interferon on hepatitis B virus infection in patients with chronic active hepatitis. N Engl J Med 295:517–522PubMedCrossRef
12.
Zurück zum Zitat Dienstag JL, Perrillo RP, Schiff ER, Bartholomew M, Vicary C, Rubin M (1995) A preliminary trial of lamivudine for chronic hepatitis B infection. N Engl J Med 333:1657–1661PubMedCrossRef Dienstag JL, Perrillo RP, Schiff ER, Bartholomew M, Vicary C, Rubin M (1995) A preliminary trial of lamivudine for chronic hepatitis B infection. N Engl J Med 333:1657–1661PubMedCrossRef
13.
Zurück zum Zitat Hadziyannis SJ, Tassopoulos NC, Heathcote EJ (2003) Adefovir dipivoxil for treatment of HbeAg-negative chronic hepatitis B. N Engl J Med 348:800–807PubMedCrossRef Hadziyannis SJ, Tassopoulos NC, Heathcote EJ (2003) Adefovir dipivoxil for treatment of HbeAg-negative chronic hepatitis B. N Engl J Med 348:800–807PubMedCrossRef
14.
Zurück zum Zitat Korenman J, Baker B, Waggoner J, et al (1991) Long-term remission of chronic hepatitis B after alpha-interferon therapy. Ann Intern Med 114:629–634PubMed Korenman J, Baker B, Waggoner J, et al (1991) Long-term remission of chronic hepatitis B after alpha-interferon therapy. Ann Intern Med 114:629–634PubMed
15.
Zurück zum Zitat Gerken G, Gomez J, Lambertico P, et al (1998) Clinical evaluation and applications of the Amplicor HBV Monitor test, a quantitative HBV DNA PCR assay. J Virol Methods 74:155–165PubMedCrossRef Gerken G, Gomez J, Lambertico P, et al (1998) Clinical evaluation and applications of the Amplicor HBV Monitor test, a quantitative HBV DNA PCR assay. J Virol Methods 74:155–165PubMedCrossRef
16.
Zurück zum Zitat Hadziyannis SJ (1995) Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment. Viral Hepat Rev 1:7–36 Hadziyannis SJ (1995) Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment. Viral Hepat Rev 1:7–36
17.
Zurück zum Zitat Brunetto MR, Oliveri F, Demartini A, Calvo P, Manzini P, Cerenzia MT, Bonino F (1991) Treatment with interferon of chronic hepatitis B associated with antibody to hepatitis B e antigen. J Hepatol 13(suppl 1):S8–11PubMedCrossRef Brunetto MR, Oliveri F, Demartini A, Calvo P, Manzini P, Cerenzia MT, Bonino F (1991) Treatment with interferon of chronic hepatitis B associated with antibody to hepatitis B e antigen. J Hepatol 13(suppl 1):S8–11PubMedCrossRef
18.
Zurück zum Zitat Brunetto MR, Oliveri F, Rocca G, Criscuolo D, Chiaberge E, Capalbo M, David E, et al (1989) Natural course and response to interferon of chronic hepatitis B accompanied by antibody to hepatitis B e antigen. Hepatology 10:198–202PubMed Brunetto MR, Oliveri F, Rocca G, Criscuolo D, Chiaberge E, Capalbo M, David E, et al (1989) Natural course and response to interferon of chronic hepatitis B accompanied by antibody to hepatitis B e antigen. Hepatology 10:198–202PubMed
19.
Zurück zum Zitat Hadziyannis S, Alexopoulou A, Papakonstantinou A, Petraki K, Manesis E (2000) Interferon treatment with or without oral ganciclovir in HBeAgnegative chronic hepatitis B: a randomized study. J Viral Hepat 7:235–240PubMedCrossRef Hadziyannis S, Alexopoulou A, Papakonstantinou A, Petraki K, Manesis E (2000) Interferon treatment with or without oral ganciclovir in HBeAgnegative chronic hepatitis B: a randomized study. J Viral Hepat 7:235–240PubMedCrossRef
20.
Zurück zum Zitat Hadziyannis SJ (1995) Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment. Viral Hepat Rev 1:7–36 Hadziyannis SJ (1995) Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment. Viral Hepat Rev 1:7–36
21.
Zurück zum Zitat Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, et al (1981) Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1:431–435PubMed Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, et al (1981) Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1:431–435PubMed
22.
Zurück zum Zitat Brunetto MR, Oliveri F, Colombatto P, et al (1995) Treatment of chronic anti-HBe–positive hepatitis B with interferon-alpha. J Hepatol 22:42–44PubMed Brunetto MR, Oliveri F, Colombatto P, et al (1995) Treatment of chronic anti-HBe–positive hepatitis B with interferon-alpha. J Hepatol 22:42–44PubMed
23.
Zurück zum Zitat Oliveri F, Santantonio T, Bellati G, et al (1999) Long term response to therapy of chronic anti-HBe–positive hepatitis B is poor independent of type and schedule of interferon. Am J Gastroenterol 94:1366–1372PubMed Oliveri F, Santantonio T, Bellati G, et al (1999) Long term response to therapy of chronic anti-HBe–positive hepatitis B is poor independent of type and schedule of interferon. Am J Gastroenterol 94:1366–1372PubMed
24.
Zurück zum Zitat Manesis K, Hadziyannis SJ (2001) Interferon-alpha treatment and retreatment of hepatitis B e antigen–negative chronic hepatitis B. Gastroenterology 121:91–100CrossRef Manesis K, Hadziyannis SJ (2001) Interferon-alpha treatment and retreatment of hepatitis B e antigen–negative chronic hepatitis B. Gastroenterology 121:91–100CrossRef
25.
Zurück zum Zitat Lampertico P, Del Ninno E, Manzin A, et al (1997) A randomized, controlled trial of a 24-month course of interferon alfa 2b in patients with chronic hepatitis B who had hepatitis B virus DNA without hepatitis B e antigen in serum. Hepatology 26:1621–1625PubMedCrossRef Lampertico P, Del Ninno E, Manzin A, et al (1997) A randomized, controlled trial of a 24-month course of interferon alfa 2b in patients with chronic hepatitis B who had hepatitis B virus DNA without hepatitis B e antigen in serum. Hepatology 26:1621–1625PubMedCrossRef
26.
Zurück zum Zitat Brunetto MR, Oliveri1 F, Coco B (2002) Outcome of anti-HBe positive chronic hepatitis B in alpha-interferon treated and untreated patients: a long term cohort study. J Hepatol 36:263–270PubMedCrossRef Brunetto MR, Oliveri1 F, Coco B (2002) Outcome of anti-HBe positive chronic hepatitis B in alpha-interferon treated and untreated patients: a long term cohort study. J Hepatol 36:263–270PubMedCrossRef
27.
Zurück zum Zitat Vinayek R, Shakil O (1997) Adverse events associated with interferon-alfa therapy in patients with chronic viral hepatitis. Viral Hep Rev 3:167–177 Vinayek R, Shakil O (1997) Adverse events associated with interferon-alfa therapy in patients with chronic viral hepatitis. Viral Hep Rev 3:167–177
28.
Zurück zum Zitat Papatheodoridis GV, Hadziyannis SJ (2001) Diagnosis and management of pre-core mutant chronic hepatitis B. J Viral Hepat 8:311–321PubMedCrossRef Papatheodoridis GV, Hadziyannis SJ (2001) Diagnosis and management of pre-core mutant chronic hepatitis B. J Viral Hepat 8:311–321PubMedCrossRef
Metadaten
Titel
Long-Term Results of Interferon Alpha Monotherapy in Patients with HBeAg-Negative Chronic Hepatitis B
verfasst von
Sabahattin Kaymakoglu
Ahmet Danalioglu
Kadir Demir
Cetin Karaca
Filiz Akyuz
Derya Onel
Selim Badur
Ugur Cevikbas
Fatih Besisik
Yilmaz Cakaloglu
Atilla Okten
Publikationsdatum
01.03.2007
Erschienen in
Digestive Diseases and Sciences / Ausgabe 3/2007
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-006-9445-1

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