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World J Gastroenterol. Oct 7, 2014; 20(37): 13284-13292
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13284
Short- and long-term outcome of interferon therapy for chronic hepatitis B infection
Yasushi Seo, Yoshihiko Yano
Yasushi Seo, Yoshihiko Yano, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
Yasushi Seo, Internal Medicine and Ophthalmology Clinic, Himeji 672-8002, Japan
Author contributions: Seo Y and Yano Y designed this work; Seo Y wrote the paper.
Correspondence to: Yasushi Seo, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. yseo@med.kobe-u.ac.jp
Telephone: +81-79-2406231 Fax: +81-79-2406232
Received: October 25, 2013
Revised: January 25, 2014
Accepted: June 26, 2014
Published online: October 7, 2014
Abstract

Hepatitis B virus (HBV) infection is a serious clinical problem worldwide. Conventional interferon (IFN)-α has been approved for the treatment of chronic hepatitis B (CHB). Short-term studies have demonstrated that IFN-based therapy is moderately effective in inducing the loss of hepatitis e antigen (HBeAg) or seroconversion (30%-40%) in HBeAg-positive patients and also produces sustained HBV DNA suppression (20%-30%) in HBeAg-negative patients. Many studies have reported a correlation between the HBV genotype and response to IFN treatment. The highest response rate to IFN treatment was found in patients infected with HBV genotype A, followed by HBV genotypes B, C, and D. The long-term effect of IFN-α on CHB has not yet been elucidated. The ability of IFN-α treatment to prevent new cirrhosis, complications associated with cirrhosis, and development of hepatocellular carcinoma (HCC) is controversial. The beneficial effect of IFN-α treatment in reducing the development of HCC has mainly been observed in treatment responders who already have cirrhosis. These inconsistent findings may be attributed to the inevitable limitations of comparisons across studies, including differences in the baseline characteristics of the study and the moderate suppression of HBV replication by IFN-α relative to nucleoside/nucleos(t)ide analogs.

Keywords: Chronic hepatitis B, Hepatitis B virus, Interferon α, Long-term outcome, Hepatocellular carcinoma

Core tip: The long-term ability of interferon (IFN)-α treatment of chronic hepatitis B virus (HBV) infections to prevent new cirrhosis, complications associated with cirrhosis, and development of hepatocellular carcinoma (HCC) is controversial. The beneficial effect of IFN-α treatment in reducing the development of HCC has mainly been observed in treatment responders who already have cirrhosis. These inconsistent findings may be due to the inevitable limitations of comparisons across studies, including differences in the baseline characteristics of the study and the moderate suppression of HBV replication by IFN-α relative to nucleoside/nucleotide analogs.