LONG-TERM OUTCOME OF HEPATITIS-B E-ANTIGEN-POSITIVE PATIENTS WITH COMPENSATED CIRRHOSIS TREATED WITH INTERFERON-ALFA

The aim of this study was to evaluate whether interferon alfa (IFN-alp ha) treatment-associated virological and biochemical remission improve s survival in a cohort of 90 white patients with compensated cirrhosis caused by hepatitis B (Child A) followed for a mean period of 7 years , Inclusion criteria were biopsy-proven cirrhosis, hepatitis B e antig en (HBeAg) positivity, abnormal serum aminotransferase levels, exclusi on of hepatitis delta virus, and absence of complications of cirrhosis , Of the 40 IFN-treated patients, 27 (67%) showed sustained HBeAg loss with alanine aminotransferase (ALT) normalization, Of the SO untreate d patients, 30 (60%) cleared HBeAg, but only 21 (42%) normalized ALT a fter HBeAg loss, Compared with the untreated patients, IFN-treated pat ients had similar cumulative rates of HBeAg clearance (P = .48), but h igher rates of ALT normalization (P = .016) and of HBsAg loss (P = .02 8). During follow-up, liver-related death occurred in 8 treated patien ts, caused by liver failure in 5 and hepatocellular carcinoma (HCC) in 3; all 8 had continued to be HBeAg-positive with elevated ALT, None o f the treated patients undergoing remission developed liver-related co mplications, At univariate analysis, life expectancy was longer in tre ated patients showing sustained remission than in those who did not (5 -year survival: 100% vs, 81%; P = .048), Fourteen untreated patients d ied (from liver failure in 10 and HCC in 4); all but 3 had continued t o be HBeAg-positive with elevated ALT, Cox's model identified age and ALT normalization as the only significant predictors of survival, In c onclusion, in patients with HBeAg-positive compensated cirrhosis, viro logical and biochemical remission following IFN therapy is associated with improved survival.