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KMID : 0616620000060020367
Journal of Soonchunhyang Medical College
2000 Volume.6 No. 2 p.367 ~ p.378
The Change of Histologic Finding and the Clinical Significance of TNF in Chronic Hepatitis B after Interferon Treatment







Abstract
Background: Interferon has been widely used in the treatment of chronic hepatitis B, but its effectiveness is debatable. The clinical indices as the loss of HBeAg, HBV DNA, and improvement of liver function are applicated to identify the effectiveness of interferon therapy, but the mechanism of hepatohistological change is not well known. We investigated the changes of histologic finding and plasma tumor necrosis factor(TNF) in the patients with chronic hepatitis B after treatment with interferon-alpha. Methods: 11 patients with chronic hepatitis B who had treated by interferon-alpha were enrolled for this study. Liver biopsy was done before and after treatment of interferon and plasma TNF was evaluated at the same time. A semiquantitative study using a histologic scoring system was applied on pre and post liver biopsy specimens and the changes of HBeAg and HBV DNA were also evaluated. Results: Among subjects, the response group, recurrence group, and non-response group based on serologic response with clearance of HBeAg were 6, 3, and 2 patients, respectively. The changes of serum ALT level and HBV DNA titer on pre and post therapy decreased significantly in the response group. The change of mean plasma TNF level in the response group decreased insignificantly to 19.4 from 19.9. The histological improvements of grading and staging were shown 4 patients in the response group. Conclusions: Serologic response with clearance of HBeAg was associated with histological improvement. The loss of HBsAg in the serum was significant indicator of reduction in the amount of HBV core antigen and HBV surface antigen in the hepatocytes. Plasma TNF level was not associated with response of interferon-alpha therapy and histologic activity.
Key Words: Histologic finding, Plasma TNF, Chronic hepatitis B, INF alpha
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