Safety and efficacy of interferon alpha-2b following prednisone withdrawal in the treatment of chronic viral hepatitis B. A case-controlled, randomised study
Department of Medicine, University of Cape Town.South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (Impact Factor: 1.63). 11/1992; 82(5):317-20.
The therapeutic effects of interferon alpha-2b (Intron A; Scherag) in patients with chronic active hepatitis caused by hepatitis B virus (HBV) were assessed in a randomised, case-controlled clinical trial conducted between January 1988 and June 1990. Treatment involved a short course of prednisone followed by interferon alpha-2b, initially 10 million U by subcutaneous injection, 3 times a week for 16 weeks. All patients were symptomatic, were known to have had hepatitis B surface antigen and hepatitis B e antigen (HBeAg) in their blood for at least 6 months, and had elevated serum aminotransferase activities with histological evidence of chronic active hepatitis. Patients with carcinoma, renal or haematological abnormalities or decompensated cirrhosis were excluded. In 6 of 10 patients randomised to receive interferon and 1 of 10 controls, HBeAg and HBV DNA were cleared from the blood during the 12-month study period (P < 0.05). An indeterminate response with clearance of HBV DNA but persistence of HBeAg was noted in 1 patient receiving interferon. Serum aminotransferase levels decreased only in those patients who had responded to treatment, but this did not reach statistical significance for the group as a whole. Histological studies, where available, showed decreased hepatic periportal necrosis in patients who underwent treatment. Two patients relapsed to HBeAg-positive status 2 months after their initial seroconversion; 1 became clear again during a repeat course of interferon. Side-effects of treatment were common and included fever, malaise, myalgias and myelosuppression. One patient developed hypothyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)
- Journal of Hepatology 03/1994; 20(2):159-62. DOI:10.1016/S0168-8278(05)80052-2 · 11.34 Impact Factor
- New England Journal of Medicine 03/1995; 332(7):444-51. DOI:10.1056/NEJM199502163320707 · 55.87 Impact Factor
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ABSTRACT: Glucocorticosteroid pretreatment may increase virologic response to interferon in hepatitis B 'e' antigen positive chronic hepatitis B Interferon is an established treatment for chronic infection with hepatitis B virus. Although it is effective, response rates are not satisfactory. In order to increase response rates glucocorticosteroid withdrawal therapy has been proposed as a pretreatment strategy. The objectives of this review were to assess the effects of the sequential combination of glucocorticosteroids and interferon compared to interferon alone in the treatment of chronic hepatitis B. Glucocorticosteroid pretreatment was associated with a significantly higher frequency of loss of hepatitis B markers (HBeAg and HBV DNA), but had no significant effect on clinical outcomes.Cochrane database of systematic reviews (Online) 02/2005; 3(3):CD000345. DOI:10.1002/14651858.CD000345.pub2 · 6.03 Impact Factor
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