Supported by the Canadian Liver Foundation.
Interferon alfa for recurrent hepatitis B infection after liver transplantation
Article first published online: 15 DEC 2005
Copyright © 1996 American Association for the Study of Liver Diseases
Liver Transplantation and Surgery
Volume 2, Issue 2, pages 132–138, March 1996
How to Cite
Terrault, N. A., Holland, C. C., Ferrell, L., Hahn, J. A., Lake, J. R., Roberts, J. P., Ascher, N. L. and Wright, T. L. (1996), Interferon alfa for recurrent hepatitis B infection after liver transplantation. Liver Transpl, 2: 132–138. doi: 10.1002/lt.500020209
- Issue published online: 15 DEC 2005
- Article first published online: 15 DEC 2005
- National Institutes of Health. Grant Number: R29A132242
- National Institute of Diabetes and Digestive and Kidney Diseases. Grant Number: DK-26743
Reinfection with hepatitis B virus (HBV) after liver transplantation is nearly universal in patients not receiving immunoprophylaxis. Because reinfection reduces graft and patient survival, treatment of recurrent infection is important. Interferon alfa (IFN-α) is an effective therapy for chronic hepatitis B infection in immunocompetent patients, but its efficacy in transplant recipients has not been established. Fourteen liver transplant recipients with recurrent hepatitis B infection (hepatitis B surface antigen [HBsAg] positive in serum; hepatitis on biopsy) were treated with IFN-α2b (Intron A; Schering Inc, Kenilworth, NJ) 3 million units (MU) three times weekly for 23.5 weeks (median, range 4 to 41). The primary endpoint was loss of HBV DNA by the b-DNA assay (a virological response). Before treatment, all patients were HBV DNA positive and 9 were hepatitis B e antigen (HBeAg) positive. Pretreatment HBV DNA levels were 6,760 MEq/mL (median, range 2.0 to 11,888 MEq/mL). HBV DNA levels decreased significantly with treatment (P = .03). Four patients had a complete and sustained virological response. Virological responses did not consistently correlate with biochemical response because of concomitant hepatitis C. Two patients had a serological response; 1 lost HBeAg, another lost HBeAg and HBsAg. All responders remained HBV DNA negative in follow-up (mean, 32 months; range, 23 to 40), but 1 patient required retransplantation for cirrhosis. Of the nonresponders, 1 patient required retransplantation for chronic rejection, 3 required retransplantation for recurrent hepatitis B, 3 died with recurrent hepatitis B, and 3 are alive and remain HBV DNA positive. IFN-α can induce a sustained serological (14%) and virological response (29%) in liver transplant recipients with recurrent HBV infection. Copyright © 1996 by the American Association for the Study of Liver Diseases.