[Effectiveness of using recombinant interferon alfa2 (reaferon) combined with antioxidants in children with acute hepatitis B]

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The authors describe the results of the first experience gained with the use of recombinant alpha 2-interferon in children with acute viral hepatitis B. The drug was administered rectally in combination with antioxidants (tocopherol). The study was carried out by the double blind method with randomization and two control groups (given tocopherol alone or placebo alone). 73 children with acute viral hepatitis B were examined. The therapeutic combination reaferon plus tocopherol was established to favour more rapid elimination of dyspeptic and abdominal phenomena, to shorten the time of the liver and spleen size increase, duration of hyperfermentemia, to provide for an accelerated reduction of HBsAg titers, elimination of HBeAg and seroconversion, to stimulate alpha-interferon production by leukocytes, and to activate the system of mononuclear phagocytes.

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... The hospital stay of the supplemented group was reduced by six days and the mortality was reduced to 6.5 percent (2 of 31 patients) compared to 40 percent (10 of 25 patients) in the control group. 77 Antioxidants have also been used in combination with interferon alfa2 in children with acute hepatitis B. One study looked at 73 children with acute hepatitis B given tocopherol and interferon alfa2 simultaneously, and found significantly shorter recovery times, higher levels of endogenous alpha-interferon, and a significant increase in the elimination of Hbe antigen with the addition of vitamin E. 78 Studies using antioxidants in hepatitis C have focused on the effect of a variety of antioxidants, both nutrients and botanicals. 79 Beloqui treated 24 patients with chronic hepatitis C, 14 who had shown no response to interferon after four months. ...
Hepatitis C is emerging as a serious worldwide problem. In the United States the current mortality figures may triple in the next ten years, rivaling HIV. The disease has a latency of 10-30 years and symptoms or signs may not appear until cirrhosis is evident. Adequate diagnosis, including liver biopsy, is essential in assessing the current stage of the viral infection and the need for treatment. Hepatitis C may manifest as hepatic fibrosis, cirrhosis, hepatocellular carcinoma, lichen planus, glomerulonephritis, mixed cryoglobulinemia, or porphyria. The hepatic damage is due both to the cytopathic effect of the virus and the inflammatory changes secondary to immune activation. The use of the botanical components glycyrrhizin, catechin, silymarin and phytosterols, and the antioxidants N-acetylcysteine and vitamin E are reviewed for their efficacy in treating chronic hepatitis and affecting liver damage.
... Two different studies reported that vitamin E plasma levels were signifi cantly lower in children with CHB; therefore, combined therapy of interferon-␣ and vitamin E should be used as therapy. 21,22 Another study suggested that an antiviral and immunomodulator preparation named Viferon, produced as rectal suppositories containing recombinant ␣ -2b-interferon and anti-oxidants, should be used in complex therapy of viral chronic hepatitis B and C in children. In this case, it was claimed that higher complete response ratios were achieved. ...
The purpose of the present paper was to investigate the efficacy of vitamin E in children with immunotolerant-phase chronic hepatitis B virus (CHB) infection. Fifty-eight immunotolerant children were prospectively and randomly recruited into two groups. Group 1 (study group) included 30 patients who received vitamin E at a dose of 100 mg/day throughout 3 months; group 2 (control group) contained 28 patients who did not receive any medication. Comparison of serological, virologic, and biochemical response ratios were done at the end of the therapy and after 6 months of vitamin E discontinuation. Mean alanine transaminase (ALT) values in group 1 at the beginning of the therapy, 3 months after the therapy initiation and 6 months after discontinuation were 30.4 +/- 7.3 IU/L, 31.3 +/- 7.8 IU/L and 32.1 +/- 8.5 IU/L, respectively. The mean hepatitis B virus (HBV)-DNA load of group 1 at onset, and at the third and ninth months of the treatment were 3106 +/- 718 pg/mL, 3530 +/- 137 pg/mL and 3364 +/- 1246 pg/mL, respectively. These changes in both ALT and HBV-DNA values did not reach significant levels (P > 0.05). In group 2, mean ALT values at the beginning of therapy, and at the third and ninth months were 28.0 +/- 1.8 IU/L, 34.6 +/- 8.1 IU/L, and 34.1 +/- 7.0 IU/L, respectively (P > 0.05), and mean viral load of HBV-DNA was 4227 +/- 1435 pg/mL, 3368 +/- 2673 pg/mL, and 3018 +/- 2814 pg/mL, respectively (P > 0.05). There was no statistically significant difference between group 1 and group 2 at the third and ninth months in the mean ALT values and viral load of HBV-DNA (P > 0.05). Hepatitis B s antigen and hepatitis B e antigen clearance or hepatitis B s antibody and hepatitis B e antibody seroconversion were not observed in either group. As a first study investigating the effect of vitamin E in children with immunotolerant CHB infection, no beneficial effect could be demonstrated. Different immunomodulator protocols should be considered for future investigations.
Several investigations in the last two decades have proven the involvement of oxidative stress in the pathogenesis of liver diseases, regardless of the cause. The impact of free radicals is documented in viral hepatitis, alcoholic and nonalcoholic steatohepatitis, ischemia/reperfusion injury, autoimmune disorders, cholestasis, hepatocellular carcinoma, and drug-induced liver injury. As a consequence, antioxidants are proposed as promising compounds for the prevention and treatment of hepatic damage. Antioxidant therapy is generally protective in cellular and animal models of most liver diseases, and this evidence led to test antioxidant drugs in hepatopatic patients. However, in current clinical practice oxidative damage is not targeted by most medical practitioners. In this chapter we will review the evidences in support of antioxidant therapy in liver diseases after a brief presentation of the role played by free radicals in their pathogenesis. © Springer-Verlag Berlin Heidelberg 2014. All rights are reserved.
Interferons are part of the body’s natural defence system. They have been shown in vitro and in vivo to possess antiviral, antitumour and immunoregulatory properties. There are two types of interferon, type I and type II. Type I interferons comprise interferon-α (IFNα) and interferon-β (IFNβ). Type II interferon is comprised solely of interferon-γ (IFNγ). Each type has distinctive genetic derivation, primary producing cells, and properties. IFNα is the most widely used interferon, and is produced commercially both by recombinant DNA technology and from stimulated leucocyte and lymphoblastoid cells. IFNβ is also available as a recombinant product and as a naturally produced product from human fibroblasts. IFNγ is available as a recombinant product. The different types of interferons cannot be used interchangeably to obtain the same results. For instance, IFNγ has been shown to aggravate multiple sclerosis, whereas IFNγ has a significant ameliorating effect. This article reviews the therapeutic use of interferons in: (a) viral infections, including condylomata acuminata, viral hepatitis and human immunodeficiency virus infection; (b) neoplastic disorders, including hairy cell leukaemia, multiple myeloma, AIDS-related Kaposi’s sarcoma, cervical neoplasia, basal cell carcinoma, squamous cell carcinoma, melanoma, renal cell carcinoma, carcinoid tumours, cutaneous T cell lymphoma and non-Hodgkin’s lymphoma; (c) myeloproliferative disorders, including chronic myelogenous leukaemia and polycythaemia vera; (d) rheumatoid disorders, including rheumatoid arthritis and systemic sclerosis; (e) other disorders, including multiple sclerosis, chronic granulomatous disease and cryoglobulinaemia. Many other diseases could have been included, but those mentioned have received the greatest amount of investigation and attention. The potential adverse effects of interferons are also discussed. There is little doubt that the full therapeutic role of interferons has yet to be fully realised, either as single agents or in combination with other cytokines or drugs.
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