TREATMENT OF POLYARTERITIS-NODOSA RELATED TO HEPATITIS-B VIRUS WITH INTERFERON-ALPHA AND PLASMA EXCHANGES

Objectives-To test the effectiveness of and tolerance to interferon-al pha 2b (INFa2b) in association with plasma exchanges for the treatment of polyarteritis nodosa (PAN) related to hepatitis B virus (HBV). Met hods-A prospective, non blinded, multicentre trial was carried out in which patients with multisystemic HBV-related PAN were included. Each patient received the association of INFa2b and plasma exchanges. The e nd point of the study was control of the disease (recovery or remissio n) or death. Results-Six patients were included in the study. Each pat ient had histopathological or arteriographic evidence of vasculitis an d was infected with actively replicating HBV. Ah patients were alive a t the end of the study and no longer presented clinical or laboratory evidence of systemic vasculitis. HBeAg/anti-HBeAb seroconversion was o bserved in four patients (66.6%) and HBsAg/anti-HBsAb in 3/6 (50%). Tw o patients are still being treated with INFa2b because of chronic acti ve hepatitis. C Conclusions-It is considered that this new therapeutic approach to HBV-related PAN effectively cured systemic vasculitis and was associated with control of HBV infections. Antiviral therapy may have a role to play as the first line treatment regime of virus-induce d vasculitis.