Long-Term Versus Short-Term Treatment With Recombinant Interferon Alfa-2a in Patients With Chronic Hepatitis B: A Prospective, Randomized Treatment Trial

JORGE RAKELA, JAMES R. WOOD, ALBERT J. CZAJA, PETER C. O'BRIEN, HOWARD F. TASWELL, BRAD A. BOWYER, STEPHEN M. LANGE, MONTE L. ANDERSON, KEVIN PARENT

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Abstract

We conducted a prospective, randomized trial to study the efficacy and tolerance of long-term versus short-term treatment with recombinant interferon alfa-2a in patients with chronic hepatitis B. Ten patients were randomly assigned to a 6-month interferon regimen, and 10 patients were assigned to a 3-week interferon trial. Eleven patients (five assigned to long-term treatment and six to short-term treatment) did not complete interferon therapy: eight had either severe thrombocytopenia or neutropenia; one had pronounced fatigue in relationship to administration of interferon; one had spontaneous bacterial peritonitis and sepsis and died; and one had a massive fatal variceal hemorrhage during interferon therapy. Most of the serious hematologic complications occurred in patients with cirrhosis and hypersplenism. In one patient, seroconversion to hepatitis B virus DNA negativity occurred before the onset of treatment. Four of the five patients able to complete the 6-month interferon regimen and only one of four patients able to complete the 3-week trial had seroconversion to hepatitis B virus DNA negativity. Thus, we conclude that the therapeutic response was better among patients who were able to complete a 6-month interferon trial. In patients with cirrhosis and hypersplenism, development of either severe thrombocytopenia or leukopenia associated with interferon therapy precluded completion of treatment.

Original languageEnglish (US)
Pages (from-to)1330-1335
Number of pages6
JournalMayo Clinic proceedings
Volume65
Issue number10
DOIs
StatePublished - Jan 1 1990

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RAKELA, JORGE., WOOD, JAMES. R., CZAJA, ALBERT. J., O'BRIEN, PETER. C., TASWELL, HOWARD. F., BOWYER, BRAD. A., LANGE, STEPHEN. M., ANDERSON, MONTE. L., & PARENT, KEVIN. (1990). Long-Term Versus Short-Term Treatment With Recombinant Interferon Alfa-2a in Patients With Chronic Hepatitis B: A Prospective, Randomized Treatment Trial. Mayo Clinic proceedings, 65(10), 1330-1335. https://doi.org/10.1016/S0025-6196(12)62144-2