Long-Term Follow-up of HBeAg-Positive Patients Treated with Interferon Alfa for Chronic Hepatitis B

Background In patients with chronic hepatitis B, treatment with interferon alfa and the consequent loss of hepatitis B e antigen (HBeAg) from the blood leads to a reduction in inflammatory activity, but the clinical benefits of this treatment have not been established. We evaluated whether HBeAg seroconversion induced by interferon alfa improves clinical outcome. Methods We studied prospectively a cohort of 103 patients treated with interferon alfa for chronic hepatitis B; the mean (±SD) follow-up was 50.0±19.8 months. Fifty-three untreated patients served as controls. Results After treatment with interferon alfa, 53 of 103 patients no longer had detectable HBeAg or hepatitis B virus DNA, although only 10 patients became seronegative for hepatitis B surface antigen (HBsAg) (Kaplan–Meier estimates of cumulative clearance rates at five years, 56.0 percent for HBeAg and 11.6 percent for HBsAg). Of the 53 untreated patients, only 7 spontaneously eliminated HBeAg (28.1 percent at five years), and all remained ...