The long-term effects of interferon alpha on clinical outcome and survival of patients with chronic hepatitis D are unclear.
In this study, scientists from Europe evaluated 36 patients with chronic hepatitis D.
Patients were randomized to receive either a 48-week course of high doses of interferon alpha (9,000,000 units), a course of low doses (3,000,000 units), or no treatment.
Patients were followed for an additional 2 to 14 years.
|High dose patients had a dramatic improvement in liver histology.|
The scientists found that long-term survival was significantly longer in the high-dose group than in either the low dose group or the controls. Long-term survival did not significantly differ between the low dose group and the control group.
After 12 years of follow-up, 7 of the 12 surviving patients in the high dose group had a biochemical response. A biochemical response was also found in 2 of the 4 surviving low dose patients.
The team found that long-term alanine aminotransferase normalization correlated with improved hepatic function and loss of IgM antibody to hepatitis delta antigen.
They determined that patients in the high-dose group had a sustained decrease in hepatitis D virus replication, leading to clearance of HDV RNA.
High dose patients also had a dramatic improvement in liver histology with respect to activity grade and fibrosis stage.
The team also found an absence of fibrosis in 4 patients with a long-term biochemical response and an initial diagnosis of active cirrhosis.
Dr Patrizia Farci and colleagues concluded, “High doses of interferon alpha-2a significantly improved the long-term clinical outcome and survival of patients with chronic hepatitis D, even though the majority had active cirrhosis before the onset of therapy”.