SHORT REPORT - PREDNISOLONE WITHDRAWAL FOLLOWED BY LYMPHOBLASTOID INTERFERON IN THE THERAPY OF ADULT PATIENTS WITH PRESUMED CHILDHOOD-ACQUIRED CHRONIC HEPATITIS-B VIRUS-INFECTION

Eighteen patients with presumed childhood acquisition of chronic hepat itis B virus infection were initially entered into this randomized con trolled trial. Twelve were treated with prednisolone for 4 weeks follo wed, after a 2-week gap, by thrice weekly lymphoblastoid alpha-interfe ron for 12 weeks. Two of these had previously acted as untreated contr ols. Three of the 12 patients (25%) [who were initially hepatitis B vi rus (HBV) surface antigen (HBsAg), 'e' antigen (HBeAg) and HBV-DNA pos itive] became HBeAg and HBV-DNA negative during therapy and remained s o after 12 months post-therapy follow-up. One of these also lost HBsAg . A further two patients lost HBeAg and HBV-DNA during therapy but rel apsed 6 and 9 months latter. Two additional patients were HBV-DNA nega tive but HBeAg positive at the end of follow-up. None of the eight unt reated control patients seroconverted during an identical follow-up pe riod. Two further patients were HBsAg and HBeAg positive but HBV-DNA n egative at the start of therapy. These were omitted from the final ana lysis: both subsequently lost HBeAg. The treatment response was associ ated with a rise in aspartate aminotransferase, peaking 2-6 weeks afte r prednisolone withdrawal, loss of HBV-DNA 0-8 weeks later and subsequ ent normalization of liver function tests. Treatment was well tolerate d.