Long-term benefit of interferon alpha therapy of chronic hepatitis D: regression of advanced hepatic fibrosis
| Autor: | Tania Roskams, Luchino Chessa, Giovanna Peddis, Valeer Desmet, Angelo Balestrieri, M Loy, Rosetta Scioscia, Anna Paola Mazzoleni, L. Caruso, Maria Eliana Lai, Giancarlo Serra, Patrizia Farci, Robert H. Purcell |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Time Factors Hepatitis D Chronic Alpha interferon Antineoplastic Agents medicine.disease_cause Gastroenterology Interferon Internal medicine medicine Humans Prospective Studies Aged Hepatitis B virus Hepatitis B Surface Antigens Hepatology biology business.industry Interferon-alpha Alanine Transaminase medicine.disease Hepatitis D Survival Analysis Alanine transaminase Liver Hepatocellular carcinoma Immunology biology.protein RNA Viral Female Hepatitis D virus Hepatitis Delta Virus business medicine.drug Follow-Up Studies |
| Zdroj: | Gastroenterology. 126(7) |
| ISSN: | 0016-5085 |
| Popis: | Background & Aims: Little is known about the long-term effects of interferon α on clinical outcome and survival of patients with chronic hepatitis D. Methods: Thirty-six patients with chronic hepatitis D who participated in a randomized controlled trial of a 48-week course of high (9 million units) or low (3 million units) doses of interferon α or no treatment were followed for an additional 2 to 14 years. Results: Long-term survival was significantly longer in the high-dose group than in untreated controls ( P = 0.003) or in the low-dose group ( P = 0.019) but did not differ between patients treated with 3 million units and controls. Among surviving patients at 12 years of follow-up, a biochemical response was present in 7 of 12 treated with 9 million units, in 2 of 4 who received 3 million units, and in none of 3 controls. Long-term alanine aminotransferase (ALT) normalization correlated with improved hepatic function and loss of IgM antibody to hepatitis delta antigen (anti-HD). Patients in the high-dose group had a sustained decrease in HDV replication ( P = 0.008), leading to clearance of HDV RNA and, eventually, hepatitis B virus (HBV) in some patients, as well as a dramatic improvement in liver histology with respect to activity grade ( P = 0.0004) and fibrosis stage ( P = 0.007). Strikingly, we documented an absence of fibrosis in the final biopsy of 4 patients with a long-term biochemical response and an initial diagnosis of active cirrhosis. Conclusions: High doses of interferon α-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. |
| Databáze: | OpenAIRE |
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