ackround : it was known that the persisten replication of hepatitis B virus in chronic active hapatitis was an important cause of developing liver cirrhosis and hepatocellular carcinoma and several antiviral agents was tried
in
protecting viral replication.
But recently, interferon functioning as an immune modulator and antiviral agents has been
tried in treating chronic active hepatitis B.
Methods : the efficacy and safety of recombinant intefron alph2b(Intron-A(R) was studied in
twenty eitght cases with HBeAg positive chronic active hepatitis(CAH). Three million untis of
interferon were administrated subcutaneously three times a week for 12 weeks.
The negativity of HBV DNA and HBeAg, activities of aminotransferase, BUN, serum
creatinine and urinalysis were floowed up for 2 years in 28 cases with HBeAg positive CAH.
The peripheral blood white blood cell, granulocyte and platelet count were followed-up for 2
years. The negativity of HBV DNA and HBeAg was regarded as persistent negativity more than
6 weeks in follow up period.
Results : the results were as follows
1) HBeAg negativity more than 6 weeks for 2 years were observed in 10 cases (37%) out
of 27 cases.
2) HBV DNA negativity more than 6 weeks for 2 years were observed in 16 cases (88%) out
of 18 cases with HBV DNA postive cases.
3) during adminstration of interferon, serum aspartate aminotransferase (AST) and alanin
aminotransferase(ALT) were decreased significantly from the 2nd week after the initial
injection to the 116th week (p<0.05).
4) the peripheral white blood cell, granulocyte and platelet counts were decreased from the
2nd week but recovered from the 6th to the 8th week in 28 cases. These were within normal
limits within 24 weeks.
5) there were no specific changes in BUN, serum creatinine and urinalysis by
alpha-interferon administration.
6) fever(89%), myalgia(89%),fatigue(67%), headache(57%),anorexia(50%),nausea(35%),skin
eruption at injected site (21%), diarrhea(17%), alopecia(7%), insomnia(3%) and severe
generalized muscle weakness (3%) were noted in the first few weeks as adverse effects. But
these were mild in all cases and subsided within first few weeks.
We stopped the injection in a case with uncontrollable severe generalized muscle
weakness at the 6th week.
Conclusion : in chronic active hepatitis B, a subcutaneous adminstration of three
million untis of interferon at interval of theree times a week for 12 weeks can be used
safely without a significantly adverse effects.
Also it may cause a loss of HBV DNA and HBeAg and reduce or normalize the titers of
aminotransferase.
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