Interferon: a sharp sword to overcome HCV or HBV-related liver diseases?

Dear Editor,

We read with great interest the article entitled "The Comparative Efficacy and Safety of Peginterferon Alpha-2a vs. 2b for the Treatment of Chronic HCV Infection: A Meta-Analysis" by Alavian et al. [1]. published in Hepatitis Monthly. In this article, the authors performed an elegant meta-analysis of randomized controlled trials to compare the different effects (including efficacy and safety) of using two types of peginterferon, alpha-2a (PEG-IFN-α2a) and 2b (PEG-IFN-α2b) in the treatment of chronic hepatitis C virus (HCV) infection. By pooling data from 7 randomized controlled trials, the authors concluded that PEG-IFN-α2a with similar safety is more effective than PEG-IFN-α2b; and that a longer duration of maximum serum concentration compared with PEG-IFN-α2b yields a greater sustained virological response and higher neutropenia in PEG-IFN-α 2a recipients. These analysis results are of important clinical directive significance for using interferon alpha (IFN-α) to treat HCV-related liver diseases.

HCV and HBV infections are major global causes of liver-related morbidity and mortality; and they are also the most common etiologies of hepatocellular carcinoma (HCC). However, IFN-α not only has antiviral activities with clearance or suppression of HBV and HCV, but also possesses anti-tumor properties including antiproliferative, antiangiogenic, and immunomodulatory effects [2][3][4]. In recent years, we and others have also done some excellent research work on this issue. In 2006 [5], we performed an immunohistochemical study of P48 staining on specimens that were collected from patients, in a randomized trial, who received postoperative IFN-a therapy (80 patients) and who did not receive postoperative IFN-a therapy (75 patients); study results indicated that P48 was useful as a predictive marker of outcome after postoperative IFN-a treatment in patients with HBV-related HCC. Owing to the fact that the included subpopulation in our study consisted mostly of HBV-positive patients, whether our study results were suitable for HCV-positive patients is still unknown; so our further research may focus on this subpopulation.

To the best of our knowledge, IFN-α has been widely used in the prevention and treatment of HCV or HBV- related liver diseases (including hepatitis, cirrhosis, HCC etc.) both in western and Asian countries; it alone or in combination with other agents might offer a good therapeutic option for patients with HCV or HBV-related liver diseases. Further explorations of the benefits of this use would be worthwhile.