Long-term follow-up of alpha-interferon treatment in patients with HBeAg-positive chronic hepatitis B.
- Author:
Dae Ro CHOI
1
;
Myoung Kuk JANG
;
Han Kook MOON
;
Seong Man KIM
;
Jun Ho LEE
;
Ja Young LEE
;
Kyung Ho KIM
;
Joon Yong PARK
;
Jin Heon LEE
;
Hak Yang KIM
;
Jae Young YOO
Author Information
1. Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea. jyyoo@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Chronic hepatitis b;
Interferon-alpha;
Hepatocellular carcinoma;
Follow-Up studies
- MeSH:
Carcinoma, Hepatocellular;
Disease Progression;
Follow-Up Studies*;
Hepatitis B;
Hepatitis B e Antigens;
Hepatitis B, Chronic*;
Hepatitis, Chronic*;
Humans;
Incidence;
Interferon-alpha*;
Interferons;
Korea;
Medical Records;
Mortality
- From:Korean Journal of Medicine
2005;69(2):150-156
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Data on the long-term effects of interferon alpha (IFN) treatment on disease progression and mortality in patients with chronic hepatitis B (CHB) are limited. To evaluate factors that influence clinical outcome and survival, we performed a follow-up study on hepatitis B e antigen (HBeAg) positive CHB patients treated with IFN. METHODS: A total of 98 patients with biopsy-proven HBeAg-positive CHB were treated with IFN- between 1988 and 2000 and followed. Data were collected by review of medical record, direct contact, or using database from Korea Central Cancer Registry. Sustained response (SR) to treatment was defined as HBeAg loss within 12 months after the end of IFN therapy and maintenance of HBeAg negativity for at least 3 years. We tried to find the factors associated with SR, hepatocellular carcinoma (HCC) incidence and survival. We also compared the cumulative rate of HCC and survival between SR group and non-sustained response (NSR)/nonresponder group. RESULTS: The mean IFN dose was 375+/-205 mega units. Mean follow-up was 92.0 months (SD 45 months). Twenty-six patients (27%) had sustained response to IFN treatment, although transient response was seen in 39% (38 out of 98 patients). Nine patients died of liver-related causes (hepatic failure, variceal bleeding) during follow-up. There were no significant differences of clinical outcomes such as survival and HCC incidence between responders and nonresponders (p=0.18, p=0.10, respectively). However, HCC developed in 6 patients, all of whom were nonresponders with an age older than 39 years. CONCLUSION: Age of 39 years and above at the time of IFN treatment might increase the risk of developing HCC. Therefore, interferon should be applied at the younger age to prevent HCC in patients with HBeAg-positive CHB.
