TREATMENT OF CHRONIC VIRAL-HEPATITIS WITH INTERFERON

Clearance of the Hepatitis B Virus is obtained in about 30-60% of the HBeAg-positive carriers of HBsAg with chronic liver disease treated with 5-10 million units/square meter of body surface of alpha-Interferon thrice weekly for 4-6 months. Oriental patients, children, immunodeficient patients are less likely to respond to the drug; patients with low viremia and high levels of transaminases seem to be the ideal candidates to therapy. Most patients (60-80%) with atypical chronic type B infections (anti-HBe-positive, HBV-DNA-positive, intrahepatic HBcAg) clear serum HBV-DNA and normalize ALT during Interferon treatment but many (80%) are prone to relapse during the follow-up. High dosages (9.000.000 Units three times per week) given for a prolonged period (12 months) are needed to control chronic HDV hepatitis. Relapses however, are frequent after discontinuation of therapy. Normalization of ALT levels and histologic improvement are achieved in about 50% of patients with chronic hepatitis C treated with Interferon (3.000.000 thrice weekly for 6 months) but relapses are frequent during the follow-up. Low levels of viraemia, viral genotype, short duration of disease, absence of cirrhosis are probably predictive factors of response. In conclusion, Interferon is effective in inhibiting viral replication in a significant number of patients with chronic type B, C and D hepatitis but new therapeutic regimens and a better selection of patients are needed in order to induce persistent remissions and to reduce the cost/benefit ratio (Fund. Clin. Immunol. 2: 101-106, 1994).