Hepatitis interferon therapy

Gunsar E, Akarca US, Ersoz G, Kobak AC, Karasu Z, Yuce G, liter T, Batur Y (2005) Two-year interferon therapy with or without ribavirin in chronic delta hepatitis. Antivir Ther 10 721-726 Habersetzer E, Boyer N, MarceUin P, Badly F, Ahmed SN, Alam J, Benhamou JP, Trepo C (2000) A pdot study of recombinant interferon beta-la for the treatment of chronic hepatitis C. Liver 20 437 41... 

Lin SM, Yu ML, Lee CM, Chien RN, Sheen IS, Chu CM, Liaw YE (2007) Interferon therapy in HBeAg positive chronic hepatitis reduces progression to cirrhosis and hepatocellular carcinoma. J Hepatol 46 45-52... 

Interferon alfa is an antiviral agent that is effective in suppressing hepatitis B viral replication. Interferon alfa-2b and pegylated interferon alfa-2a are the only interferon therapies approved for the treatment of chronic hepatitis B. 

Neutropenia associated with interferon or pegylated interferon therapy is defined as an absolute neutrophil count (ANC) of less than 1000 cells/mm3 in rare cases, an ANC less than 500 cells/mm3 maybe observed. The neutropenia is more common and in some cases more severe with pegylated interferon than with unmodified interferon. Neutropenia usually occurs within the first 2 weeks after initiating either formulation of interferon, with the WBC count stabilizing by week four or six. The neutropenia is reversible upon discontinuing therapy. Granulocyte colony-stimulating factor has been used as an adjunctive therapy for interferon-induced neutropenia in hepatitis patients.44... 

While there are no FDA-approved treatments for hepatitis D, interferon has been shown to be effective.46 48 Various doses have been evaluated, with the most effective treatment being 9 million units three times weekly.47 Seventy-one percent of patients who were treated with this regimen for 48 weeks had normalized ALT levels.47 Adverse effects and monitoring parameters for interferon therapy are similar to treatment for hepatitis C. In some situations, patients infected with hepatitis D who develop hepatic decompensation and ESLD may need to undergo liver transplantation. 

Carreno, V., et al. (1992). Long-term follow-up of hepatitis B chronic carriers who responded to interferon therapy. J. Hepatol. 15, 102-106. 

McHutchinson, J. G., etal. (1997). Hepatitis C and G co-infection Response to interferon therapy and quantitative changes in serum HGV-RNA. Hepatology 26, 1322-1327. 

Hepatitis B therapy interferon alfa-2a interferon alfa-2b... 

Hepatitis C therapy interferon alfa-2b/ribavirin peginterferon-2b peginterferon alfa-2b/ribavirin... 

Interferon therapy should be used with great caution in patients with decompensated cirrhosis since treatment may flare their disease, resulting in hepatic failure, and is often associated with significant cytopenia or infection [30,31]. Other ab-... 

Di Bisceglie, A.M.,T.L. Fong, M.W. Fried, et al., A randomized controlled trial of recombinant alpha-interferon therapy for chronic hepatitis B. Am 1 Gastroenterol, 1993. 88 1887-92. 

Brook, M.G., P. Karayiannis, and H.C. Thomas, Which patients with chronic hepatitis B virus infection will respond to alpha-interferon therapy A statistical analysis of predictive factors. Hepatology, 1989. 10 761-63. 

Shindo, M., A.M. Di Bisceglie, L. Cheung, et al.. Decrease in serum hepatitis C viral RNA during alpha-interferon therapy for chronic hepatitis C. Ann Intern Med,1991.115 700-4. 

B. Indications and nse Infergen is indicated for treating chronic hepatitis C virus (HCV) infection in adults with compensated liver disease who have anti-HCV serum antibodies and/or the presence of HCV RNA. It is also effective in the subsequent treatment of patients who did not respond or relapsed after initial interferon therapy. In some patients with chronic HCV infection, Infergen normalizes serum alanine aminotransferase (ALT) concentrations, reduces serum HCV RNA concentrations to undetectable quantities (<100 copies/ml), and improves liver histology. 

Wong V, Fu AX, George J, Cheung NW. Thyrotoxicosis induced by alpha-interferon therapy in chronic viral hepatitis. Clin Endocrinol (Oxf) 2002 56(6) 793-8. 

Fernandez-Soto L, Gonzalez A, Escobar-Jimenez F, Vazquez R, Ocete E, Olea N, Salmeron J. Increased risk of autoimmune thyroid disease in hepatitis C vs hepatitis B before, during, and after discontinuing interferon therapy. Arch Intern Med 1998 158(13) 1445-8. 

Mofredj A, Howaizi M, Grasset D, Licht H, Loison S, Devergie B, Demontis R, Cadranel JF. Diabetes mellitus during interferon therapy for chronic viral hepatitis. Dig Dis Sci 2002 47(7) 1649-54. 

Fabris P, Betterle C, Greggio NA, Zanchetta R, Bosi E, Biasin MR, de Lalla F. Insulin-dependent diabetes mellitus during alpha-interferon therapy for chronic viral hepatitis. J Hepatol 1998 28(3) 514—7. 

Fabris P, Floreani A, Tositti G, Vergani D, De Lalla F, Betterle C. Type 1 diabetes mellitus in patients with chronic hepatitis C before and after interferon therapy. Aliment Pharmacol Ther 2003 18 549-58. 

M. Guido, M. Rugge, L. Chemello, G. Leandro, G. Fattovich, G. Giustina, M. Cassaro, and A. Alberti, Liver stellate cells in chronic viral hepatitis the effect of interferon therapy, J. Hepatol. 24 301-307 (1996). 

V. Carreno, J. Bartolome, and I. Castillo, Long-term effect of interferon therapy in chronic hepatitis B, J. Hepatol. 20 431-435 (1994). 

Barnes, E., G. Webster, S. Whalley, and G. Dusheiko. 1999. Predictors of a favorable response to a interferon therapy for hepatitis C. Clin. Liver Dis. 3 ... 

Hosoda S, Takimura H, Shibayama M, Kanamura H, Ikeda K, Kumada H. Psychiatric symptoms related to interferon therapy for chronic hepatitis C clinical features and prognosis. Psychiatry Clin Neurosci 2000 54(5) 565-72. 

Scalori A, Apale P, Panizzuti F, Mascoli N, Pioltelli P, Pozzi M, Redaelli A, Roffi L, Mancia G. Depression during interferon therapy for chronic viral hepatitis early identification of patients at risk by means of a computerized test. Eur J Gastroenterol Hepatol 2000 12(5) 505-9. 

Janssen HL, Brouwer JT, van der Mast RC, Schalm SW. Suicide associated with alfa-interferon therapy for chronic viral hepatitis. J Hepatol 1994 21(2) 241-3. 

In chronic hepatitis B, 5-10% of cases display ANA and/or SMA. Due to the subtle differentiation achieved with HBV markers, it is possible to classify each individual case reliably. Prognosis and therapy are determined by chronic hepatitis B. Interferon therapy can trigger or exacerbate autoimmune hepatitis. (13, 66, 74, 78)... 

Interferon The occurrence of AIH during the treatment of chronic hepatitis B with interferon has already been described (13), as have manifestations and new episodes of inflammation caused by interferon in patients with AIH and chronic hepatitis C. (32, 66, 78) The indication for interferon therapy has to be considered with caution in cases of chronic viral hepatitis with concurrent AIH or autoimmune cholangitis it should also be monitored with great care. In replicative chronic hepatitis B, B/D or C, the chronic viral hepatitis constitutes the major factor - whereas AIH is seen as a concomitant phenomenon. Immunosuppressive therapy is not indicated. In addition, as recent studies show, there are also differences within the HCV infection itself for example, 90% of HCV carriers in Japan and 20% of those in the USA and Germany are at the same time HGV carriers (GB-C). The GB-C and HGV hepatitis viruses are designated defective because they require completion by the helper virus HCV. (s. p. 450)... 

Ruiz-Mureno, M., Rua, M.J., Carreno, V, Quironga, J.A., Manns, M., Meyer zum Biischenfelde, K.-H. Autoimmune chronic active hepatitis type 2 manifested during interferon therapy in children. J. Hepatol. 1991 12 265 - 266... 

Iron removal Increased iron and ferritin levels are found in approx. 30% of patients with chronic hepatitis B or C. Several studies have shown that the success rate of interferon therapy is reduced in the presence of elevated liver iron values. This is attributed to the fact that iron overload inhibits not only lymphocyte proliferation, but also the function of killer cells and B cells as well as the production of antibodies. Iron plays a role in the formation of free radicals and the occurrence of dangerous lipid peroxidations, (s. pp 68, 401) Furthermore, iron, like oxygen radicals, promotes fibrogenesis. Iron removal leads to an improvement in laboratory parameters and better response to interferon-a therapy. (217, 243) On the other hand, the iron level is reduced as a result of successful IFN therapy. In the case of a higher serum iron status before the initiation of interferon therapy, venesections at one week intervals should be considered, if necessary until normal laboratory values (iron, ferritin, transferrin saturation) have been restored. During interferon therapy, a low-iron diet is advisable, as is the consumption of 2 x 1 cup of black tea (in the morning and at noon) to reduce iron absorption through chelate formation ( cheap, free of side effects and useful )- (s. p. 625) Silymarin also leads to iron mobilization due to chelate formation. 

H. Efficacy of interferon retreatment after relapse for chronic hepatitis C patients with biochemical response after first interferon therapy. J. Gastroenterol. 2004 39 455-460... 

Di Bisceglie, A.M., Bonkovsky, H.L., Chopra, S., Flamm, S., Reddy, R.K., Grace, N., Killenberg, P., Hunt, C., Tamburro, C., Tavill, A.S., Ferguson, R., Krawitt, E., Banner, B., Bacon, B.R. Iron reduction as an adjuvant to interferon therapy in patients with chronic hepatitis C who have previously not responded to interferon a multicenter, prospective, randomized, controlled trial. Hepatology 2000 32 135-138... 

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