Long-term follow-up of patients with chronic hepatitis B after interferon treatment.

We investigated the long-term effect of interferon-alpha treatment in patients with chronic hepatitis B with regard to the response status during treatment. 97 patients with chronic hepatitis B, including 18 patients with active cirrhosis Child A, were followed for 12-110 months (mean: 40.5 months) after interferon-alpha treatment. At the end of treatment complete response with loss of HBeAg and HBV-DNA was observed in 32 patients, partial response with loss of HBV-DNA in 30 patients and non-response with persistence of HBeAg and HBV-DNA in 35 patients. Overall, delayed virological improvement was observed in 43% of the 97 patients during follow-up. Delayed clearance of HBsAg occurred more frequently in complete responders (25%) than in partial responders (13%, P = n. s.) and non-responders (3% p = 0.0217). 39% of the partial and non-responders lost HBeAg during the follow-up period. HBsAg and HBeAg clearance rates were increased in female patients compared to males (HBsAg: 21% vs. 12%, p = n. s.; HBeAg: 47% vs. 32%, p = 0.0045). Reactivation of the disease was seen in 28% of the complete responders. In the 18 patients with active cirrhosis, short- and long-term response rates were impaired. Only, 4/18 patients had a complete response during treatment and two of these patients suffered reactivation during follow-up. One patient underwent liver transplantation and five patients died due to complications of cirrhosis. Thus, in patients without apparent cirrhosis interferon-alpha treatment has a considerable long-term effect with regard to the enhanced rate of HBsAg and HBeAg clearance during prolonged follow-up.