Diminished responsiveness of male homosexual chronic hepatitis B virus carriers with HTLV-III antibodies to recombinant α-interferon

Authors

  • J. A. McDonald,

    1. Academic Department of Medicine, Royal Free Hospital, London NW3 2QG, England
    2. Department of Genitourinary Medicine, St. Mary's Hospital, London W2 1NY, England
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  • L. Caruso,

    1. Academic Department of Medicine, Royal Free Hospital, London NW3 2QG, England
    2. Department of Genitourinary Medicine, St. Mary's Hospital, London W2 1NY, England
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  • P. Karayiannis,

    1. Academic Department of Medicine, Royal Free Hospital, London NW3 2QG, England
    2. Department of Genitourinary Medicine, St. Mary's Hospital, London W2 1NY, England
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  • L. J. Scully,

    1. Academic Department of Medicine, Royal Free Hospital, London NW3 2QG, England
    2. Department of Genitourinary Medicine, St. Mary's Hospital, London W2 1NY, England
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  • J. R. W. Harris,

    1. Academic Department of Medicine, Royal Free Hospital, London NW3 2QG, England
    2. Department of Genitourinary Medicine, St. Mary's Hospital, London W2 1NY, England
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  • G. E. Forster,

    1. Academic Department of Medicine, Royal Free Hospital, London NW3 2QG, England
    2. Department of Genitourinary Medicine, St. Mary's Hospital, London W2 1NY, England
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  • Professor H. C. Thomas M.D.

    Corresponding author
    1. Academic Department of Medicine, Royal Free Hospital, London NW3 2QG, England
    2. Department of Genitourinary Medicine, St. Mary's Hospital, London W2 1NY, England
    • Academic Department of Medicine, Royal Free Hospital, Pond Street, London NW3 2QG, England
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Abstract

In a randomized controlled trial, 41 chronic hepatitis B virus carriers were allocated, by opening numbered computerized randomization envelopes, to receive recombinant interferon-α2A at three different doses: 2.5; 5.0, and 10.0 mU per m2. Thirty-two patients received treatment (6 for 3 months, 26 for 6 months), and 9 patients were controls (received no treatment). Ninety-three per cent of our patients were homosexual, and 41% had anti-HTLV-III in their serum

None of the control patients lost HBeAg. In contrast, six of the anti-HTLV-III-negative patients (33%) responded to treatment (p < 0.02): five of these responders were homosexual (p < 0.05). The response rate was greatest (44%) in the anti-HTLV-III-negative patients who received 10 mU per m2 of recombinant interferon-α2A. None of the anti-HTLV-III-positive patients responded to treatment. The percentage reduction of hepatitis B virus DNA was significantly less in the anti-HTLV-III-positive group in comparison to the anti-HTLV-III-negative group at 1 and 4 months of treatment and at 3 months after the end of treatment (p < 0.05). These patients were younger (33 vs. 42 years, p < 0.02), had lower mean baseline AST values (42 vs. 80 IU per liter, p < 0.02) and tended to have milder histo-logical disease

Homosexual men with HBeAg-positive chronic liver disease who are anti-HTLV-III-positive appear to be less responsive to the direct antiviral and immunomodulatory effects of recombinant interferon-α2A. This may be due to the subclinical immunosuppressive effects of co-infection with HTLV-III.

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