Interferon alfa
In about one third of adults and children with chronic hepatitis B, treatment with interferon alfa-2b leads to loss of HBeAg, return to normal aminotransferase activity, sustained histological improvement and, in adults, a lower risk of progressive liver disease. However, AIDS patients coinfected with hepatitis B virus (HBV) generally respond poorly to interferon. Hepatitis D (hepatitis delta virus), which occurs only in patients infected with HBV, may respond to treatment with high doses of interferon alfa, but relapse is common.
Peginterferon alfa-2a may be superior to conventional interferon (WG Cooksley et al, J Viral Hepat 2003; 10:298) and has been associated with higher rates of sustained response than lamivudine in patients with HBeAg-negative chronic hepatitis B (P Marcellin et al, N Engl J Med 2004; 351:1206). Peginterferon alfa-2b monotherapy has been effective for patients with HBeAg-positive chronic hepatitis B; addition of lamivu- dine was not superior to monotherapy (HL Janssen et al, Lancet 2005; 365:123).