INTERFERON TREATMENT IN PATIENTS WITH CHRONIC HEPATITIS-B - A METAANALYSIS OF THE PUBLISHED LITERATURE

The randomised clinical trials testing the effectiveness of interferon treatment on Chronic Hepatitis B patients were reviewed by means of m eta-analysis. Twenty-two trials, published between 1987 and 1990, have identified where 1290 adult patients had been studied. Overall, inter feron increased the rates of serum HBV-DNA clearance and aminotransfer ases normalization about 3 times at one year. However, when an analysi s of internal consistency, clinical relevance and methodology of these studies was made, the trials were not sufficient to confirm the clini cal effectiveness of the treatment since they had been planned for sho rt-term assessment based on biochemical and viral end points alone. Th e link of these end points to other outcomes of more obvious clinical relevance (i.e. evolution to cirrhosis or deterioration of cirrhosis, death) is, in fact, questionable and thus the value of a meta-analysis based on currently available trials is uncertain as a source for prac tical guidelines. We conclude that the effectiveness of interferon in patients with chronic hepatitis B has yet to be confirmed by long-term prospective studies which assess the outcome by clinically meaningful end points such as cirrhosis, liver failure, or death.