Virological response to interferon therapy of chronic hepatitis B as measured by a highly sensitive assay

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Journal of Viral Hepatitis 8 (5), 349-357

© Blackwell Science Ltd

Virological response to interferon therapy of chronic hepatitis B as

measured by a highly sensitive assay

Lindh, Hannoun, Horal, Krogsgaard and the INTERPRED Study Group

1 Department of Clinical Virology, Göteborg University, Göteborg,

Sweden, and Clinical Research Unit, Hvidovre Hospital, Copenhagen, Denmark

In the interferon (IFN) treatment of chronic hepatitis B, there is no

accepted definition of virological response as measured by highly sensitive

HBV DNA assays. In the present study of 98 patients given IFN (10 MU/day for

1 week, then 10 MU TIW for 11 weeks) with or without prednisolone priming, a

virological response was identified as log HBV DNA/mL below 6.0 (by Amplicor

Monitor, Roche) 6 months post-treatment. At this time, 92% (33/36) of the

sustained responders (SR) still had detectable viraemia with log HBV DNA/mL

at 4.30 ± 0.15 (± SEM), as compared with 8.69 ± 0.097 in nonsustained

responders. Pretreatment viraemia below a threshold at 500 million copies/mL

was associated with higher chance of response (P=0.023). Prednisolone

enhanced the sustained response (53% vs. 30%, P=0.025), and in particular

end-of-treatment response (ETR, 50% vs. 10%, P < 0.0001). ETR was predictive

for SR (P < 0.0001), especially when log HBV DNA/mL was < 4.0 (PPV=92%). The

potential value of differentiating the therapy of chronic hepatitis B on the

basis of viraemia levels, as measured by highly sensitive assays, should be

further investigated.