INTERFERON-ALFA TREATMENT OF CHRONIC HEPATITIS-B - RANDOMIZED TRIAL IN A PREDOMINANTLY HOMOSEXUAL MALE-POPULATION

Background/Aims: It has been suggested that human immunodeficiency vir us (HIV) coinfection and male homosexuality predict poor response to i nterferon alfa therapy of chronic hepatitis B. The aim of this study w as to examine the effect of HIV coinfection on the response of chronic hepatitis B virus (HBV) infection to interferon alfa therapy in a pre dominantly homosexual male population, Methods: Fifty patients (82% ma le homosexuals, 50% HIV positive) with evidence of chronic HBV infecti on were randomized, stratified by HIV status, to undergo either treatm ent with interferon alfa (10 MU/m(2) three times weekly for 12 weeks) or no treatment. Response was predefined as loss of serum HBV DNA, los s of hepatitis B e antigen, and the appearance of antibody to hepatiti s B e antigen. HIV status and the interferon alfa-associated enzyme, 2 ',5'-oligoadenylate synthetase, were evaluated as potential predictors of response to therapy. Results: Six treated patients responded with development of antibodies to hepatitis B e antigen (P < 0.05). HIV-pos itive patients were about one-fifth as likely to respond to interferon alfa therapy (relative risk, 0.22; 95% confidence interval, 0.03-1.78 ). Pretreatment alanine aminotransferase levels were significantly hig her in responders than in nonresponders (P = 0.0005). Pretreatment 2', 5'-oligoadenylate synthetase levels did not predict response. Conclusi ons: Interferon alfa, 10 MU/m(2) three times weekly for 12 weeks, is e ffective in eradicating HBV replication in a predominantly homosexual male population not coinfected with HIV.