BACKGROUND/AIMS: This study aimed to evaluate the effect of interferon-alpha therapy on the long-term outcome of HBeAg-negative chronic hepatitis B. METHODS: A cohort of 209 interferon-alpha treated and 195 untreated patients with histologically documented HBeAg-negative chronic hepatitis B were closely followed for a mean of 6 (1-13.5) years. Patients with decompensated liver disease and/or hepatocellular carcinoma at presentation were excluded. RESULTS: Survival and complication (liver decompensation and/or hepatocellular carcinoma) -free survival were significantly worse in patients with compared to those without baseline cirrhosis and in patients older compared to those younger than 45 years (P < 10(-4)). Sustained biochemical remission was achieved in 57 treated patients. Sustained responders had significantly better survival and complication-free survival than non-sustained responders (P = 0.027 and P = 0.019, respectively) or than untreated patients (P = 0.048 and P = 0.012, respectively). Multivariate analysis showed that absence of baseline cirrhosis, younger age, and sustained biochemical remission were independently associated with an improved outcome. CONCLUSION: In patients with HBeAg-negative chronic hepatitis B, sustained biochemical remission induced by interferon-alpha is associated with improved long-term outcome, even in the presence of cirrhosis and old age, both known factors associated with worse survival. Therefore, long-term biochemical remission appears to represent a satisfactory therapeutic target in this setting.
BACKGROUND/AIMS: This study aimed to evaluate the effect of interferon-alpha therapy on the long-term outcome of HBeAg-negative chronic hepatitis B. METHODS: A cohort of 209 interferon-alpha treated and 195 untreated patients with histologically documented HBeAg-negative chronic hepatitis B were closely followed for a mean of 6 (1-13.5) years. Patients with decompensated liver disease and/or hepatocellular carcinoma at presentation were excluded. RESULTS: Survival and complication (liver decompensation and/or hepatocellular carcinoma) -free survival were significantly worse in patients with compared to those without baseline cirrhosis and in patients older compared to those younger than 45 years (P < 10(-4)). Sustained biochemical remission was achieved in 57 treated patients. Sustained responders had significantly better survival and complication-free survival than non-sustained responders (P = 0.027 and P = 0.019, respectively) or than untreated patients (P = 0.048 and P = 0.012, respectively). Multivariate analysis showed that absence of baseline cirrhosis, younger age, and sustained biochemical remission were independently associated with an improved outcome. CONCLUSION: In patients with HBeAg-negative chronic hepatitis B, sustained biochemical remission induced by interferon-alpha is associated with improved long-term outcome, even in the presence of cirrhosis and old age, both known factors associated with worse survival. Therefore, long-term biochemical remission appears to represent a satisfactory therapeutic target in this setting.
Authors: Morris Sherman; Vincent Bain; Jean-Pierre Villeneuve; Robert P Myers; Curtis Cooper; Steven Martin; Catherine Lowe Journal: Can J Infect Dis Med Microbiol Date: 2004-11 Impact factor: 2.471