Alpha-interferon has emerged as the most effective agent for the treatment of
chronic hepatitis when active replication of virus B, C, or D is present. Exogenous administration of human
alpha-interferon, now possible through modern large-scale production methods, is associated with suppression of virus in blood. Amelioration of
liver disease occurs in 35% of patients with hepatitis B virus and in 50% with hepatitis C virus with
interferon doses of 30 and 10 MU per week, respectively, for 16-26 weeks; after
therapy, persistent normalization of serum
alanine aminotransferase is observed in 35% and 27%, respectively. Similar results have now also been reported for
chronic hepatitis D. Enhanced response rates (greater than 50%) may be obtained by prolonged intermittent
interferon therapy. Combination of
interferon with another '
antiviral' agent (
vidarabine,
acyclovir,
prednisone) has not increased therapeutic efficacy.
Alpha-interferon induces side effects such as
fatigue, flu-like syndrome,
myalgia, and changes in mood and granulocytes. Patients with decompensated
cirrhosis are particularly prone to
bacterial infection and
disease exacerbation and should receive lower doses.
Interferon, when applied skillfully, induces the highly beneficial transition of active viral replication into viral latency, thereby greatly reducing infectivity, symptoms, and activity of the
liver disease. Prevention of death from
liver failure or
hepatocellular carcinoma is to be expected.