Current status of interferon alpha in the treatment of chronic hepatitis B

Abstract

Interferon alpha is the only available therapy for patients with chronic hepatitis B. With interferon alpha 3-15 MU thrice weekly or 5 MU daily during 3-6 months one-third of the patients achieve seroconversion of HBeAg and HBV-DNA together with normalization of aminotransferases and slight improvement of histology. Loss of HBsAg is reported in a minority of responders during treatment, but increases during follow-up. Patients with baseline alanine aminotransferase of at least twice the upper limit of normal and low HBV-DNA concentration achieve the best response rates. HIV-positive patients with low CD4 counts and Asians are poor responders. As side-effects influenza-like symptoms are experienced by almost all patients. Mild leukopenia, thrombocytopenia and decreased hairgrowth are frequently reported. Severe depression, depersonalization and psychosis are reported in a small number of patients but tend to be poorly recognized in some studies. The decision whether dose reduction is indicated seems strongly related to the opinion of the investigator. Although long-term effects on the occurrence of cirrhosis and the development of hepatocellular carcinoma are not available yet, the achieved results are promising.

The role of weight status, gender and self-esteem in following a diet among middle-school children in Sicily (Italy)

“…The word diet , for children or adolescents, can embrace several unhealthy eating habits therefore the concept was explained to the participants before filling in the questionnaire. Self-esteem was calculated through the Multidimensional Self Concept Scale (MSCS) proposed and validated by Braken [18] and being part of a review on self-esteem scales for Children and Adolescents [19]. This 150-item self-report scale assesses global self-concept as a composite of six environmental contexts (domains): Social, Competence, Affect, Academic, Family and Physical.…”

Short‐ and long‐term effects of treatment of chronic hepatitis B and delta virus by IFN

“…There are many studies which are dealing with the treatment of chronic HBV infection where different type, dose and duration of INF has been used. Early studies showed that a thrice weekly or daily schedule <3 months was ineffective and recurrences of viral replication were observed after cessation of IFN [15,25]. Individual patient data from 10 clinical controlled trials showed that IFN administered at a dose of 15–30 Million Unit (MU) per week should be considered effective after 1–2 months of treatment [26].…”

“…The main goals of antiviral therapy [6,10,13,15] are to: • eradicate the virus or to convert patients from a high replicative phase to a low one (HBeAg seroconversion to anti-HBe with loss of detectable serum HBV-DNA); • provide normal or lowered ALT levels;…”

“…Interferons act mainly as antiviral, immune modulatory and antiproliferative agents by several mechanisms, including the inhibition of protein synthesis, inactivation of viral RNA and enhancement of phagocytic and cytotoxic mechanisms [6,[15][16][17][18]. Of the three IFNs, alpha IFN has shown the most benefit in patients with chronic viral hepatitis [6,8,15,18,19].…”

“…Interferons act mainly as antiviral, immune modulatory and antiproliferative agents by several mechanisms, including the inhibition of protein synthesis, inactivation of viral RNA and enhancement of phagocytic and cytotoxic mechanisms [6,[15][16][17][18]. Of the three IFNs, alpha IFN has shown the most benefit in patients with chronic viral hepatitis [6,8,15,18,19]. The patients who have HBsAg (+), HBV-DNA (+), HBeAg (+) or ()), chronic active hepatitis proven by liver biopsy, elevated liver transaminases should be treated by IFN-a unless there is a contraindication such as pregnancy, serious medical illness with life expectancy of less than 6 months, low haematocrit (<30%), platelet (<70000/mm 3 ) and neutrophil levels (<1500/mm 3 ), decompansated liver disease, several psychiatric symptoms and autoimmune disorders [6,13,14].…”