AI Article Synopsis
- One-third of patients with chronic hepatitis B achieve remission after interferon alfa (IFN-alpha) therapy, prompting this study to assess long-term outcomes.
- The study followed 103 patients from 1984 to 1994, revealing that 30% responded well to therapy, with responders showing better long-term serological status than nonresponders.
- While overall rates of liver complications and mortality were similar between responders and nonresponders, those who didn't respond had significantly worse outcomes when cirrhosis was factored in.
Article Abstract
Background & Aims: Therapy with interferon alfa (IFN-alpha) leads to remission of disease in one third of patients with chronic hepatitis B. The aim of this study was to better define the long-term prognosis of this outcome.
Methods: One hundred three patients with chronic hepatitis B who underwent IFN-alpha therapy in three clinical trials between 1984 and 1991 were followed up for serological status, biochemical evidence of liver disease, and liver complications or mortality through 1994.
Results: Among 103 patients, 31 (30%) responded to therapy with loss of hepatitis B e antigen and viral DNA from serum. Responders were more likely than nonresponders to be women, black, and to have more severe liver disease including cirrhosis (P < 0.05). Up to 11 years (mean, 6.2 years) after therapy, a higher percentage of responders than nonresponders were still negative for hepatitis B e antigen (94% vs. 40%; P < 0.001) and hepatitis B surface antigen (71% vs 8.3%; P < 0.001). Overall, the rate of liver-related complications and death did not differ by IFN-alpha response, but with adjustment for cirrhosis, nonresponders had higher rates of liver-related complications and mortality (hazard ratio, 13.7; 95% confidence interval, 3.0-63.5).
Conclusions: The response to IFN-alpha therapy in chronic hepatitis B is usually a sustained improvement in disease markers and, when cirrhosis is considered, patient outcome.
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| http://dx.doi.org/10.1053/gast.1997.v113.pm9352870 | DOI Listing |
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