Sequential combination of glucocorticosteroids and alfa interferon versus alfa interferon alone for HBeAg-positive chronic hepatitis B

Agreement between reported use of interventions for liver diseases and research evidence in Cochrane systematic reviews

“…Hepatitis B Yeast derived hepatitis B vaccine [15] Glucocorticosteroids and interferon [36] Ursodeoxycholic acid [24] Chinese medical herbs [38,39] Based on the Cochrane systematic reviews, three interventions were classified as 'evidence-based', 19 interventions as 'possibly evidence-based' (Table 1), and 14 interventions as 'not evidence-based' ( Table 2). The 'evidence-based' interventions were n-acetylcysteine for paracetamol overdose [22], terlipressin for bleeding oesophageal varices [26], and antibiotic prophylaxis for patients with cirrhosis and bleeding oesophageal varices [42].…”

Current treatment of chronic HBV infection: An Asian-Pacific perspective

“…This rate may be improved by corticosteroid priming before IFN therapy because the recovery of immune function after steroid withdrawal may result in ALT fl ares and enhance the effect of IFN [21,22]. A meta-analysis involving 790 patients in 13 randomized trials also showed that this approach was associated with signifi cantly more frequent loss of HBeAg (P = 0.03) and HBV DNA (P = 0.0008), particularly in Asian patients with lower ALT levels and when a lower dose of corticosteroid was used [23]. IFN-α therapy in compensated cirrhotic patients is safe and even more effective than in noncirrhotic patients [14].…”

What can be done about hepatitis B?

“…Interferon alfa has both antiviral and immunomodulatory activity and is established treatment for chronic hepatitis B infection 19. Seroconversion from HBeAg to anti-HBe occurs in around 35% of patients treated with the drug, compared with 10-20% with no treatment 19.…”

“…Seroconversion from HBeAg to anti-HBe occurs in around 35% of patients treated with the drug, compared with 10-20% with no treatment 19. Pretreatment with a corticosteroid increases the loss of both HBeAg and hepatitis B DNA but does not increase the rate of seroconversion 19.…”

“…Seroconversion from HBeAg to anti-HBe occurs in around 35% of patients treated with the drug, compared with 10-20% with no treatment 19. Pretreatment with a corticosteroid increases the loss of both HBeAg and hepatitis B DNA but does not increase the rate of seroconversion 19. Pegylation of interferon to form peginterferon slows the rate of absorption and excretion of interferon, allowing peginterferon to be given once weekly compared with three times weekly for standard interferon.…”