Alpha-interferon has emerged as the most effective agent for the treatment of
chronic hepatitis when active replication of virus B or D is present. Exogenous administration of human
alpha-interferon, now possible through modern large-scale production methods, is associated with disappearance of virus from blood. Amelioration of
liver disease occurs in 35% of patients with
chronic hepatitis B (e-positive) with
interferon doses of 10 MU thrice weekly for 16 weeks; after
therapy persistent normalization of serum
aminotransferases is observed in 30%. Improvement in
liver disease has only occasionally been documented for
chronic hepatitis D and for
chronic hepatitis B e-minus mutant. Enhanced response rates (> 50%) may possibly 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. Patients with decompensated
cirrhosis are particularly prone to
bacterial infection and
disease exacerbation and should receive lower-than-normal 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.