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TITLE:

EFFECT OF INDIGENOUS INTERFERON - ALPHA ON HEPATITIS B VIRUS DEOXYRIBONUCLEIC ACID LEVEL IN HEPATITIS B E ANTIGEN-POSITIVE CHRONIC HEPATITIS B PATIENTS

AUTHORS:

Dr.Muhammad Bilal, Dr.Abdul Rauf, Dr.Arslan Ahmad Bakhsh

ABSTRACT:

Background and Objective: HBeAg‑positive patients of chronic hepatitis B, show high levels of serum HBV DNA and demonstrate higher levels of viral replication. Treatment of hepatitis B has a goal to achieve prevention of cirrhosis, hepatic failure and hepatocellular carcinoma by serum alanine transaminase (ALT) normalization, however, the decrease in serum hepatitis B virus (HBV) deoxyribonucleic acid (DNA) and loss in hepatitis B e antigen (HBeAg). Interferons (IFNs) have antiviral, anti‑proliferative, and immunomodulatory effects. IFN is effective in suppressing HBV replication and in inducing remission of liver disease. Materials and Methods: This is a prospective and single treatment results study, HBeAg‑positive chronic hepatitis patients without decompensated liver disease were enrolled to receive indigenous recombinant IFN‑ 2b in the dose of 5 MU daily for 6 days a week subcutaneously for 16 weeks. The surface antigens (HBsAg), of Quantitative HBV‑DNA, HBeAg, and hepatitis B, were assessed at the end of treatment. ALT level assessment was done at baseline and during therapy at week 1, week 2, week 8, week 12, and week 16. Results: Out of 37 patients included in our study initially, 8 patients (21.62%) failed to complete the study because they didn’t follow-up, some discontinued due to adverse events happened in their lives (3 patients), and some had withdrawn the consent (2 patients). 29 patients were the final participants of the study who have completed the follow-up, 10 patients (34.48%) had clearance of HBeAg and only one patient (3.44%) had lost HBsAg after 16 weeks of therapy. Mean ALT level started decreasing after 4 weeks of therapy but did not come to normal range till 16 weeks of therapy. At least two log decreases in HBV DNA was observed in 9 (31.03%) patients and at least one log decrease in 18 (62.06%) patients. Overall decline in HBV DNA level was observed in 62% patients after 16 weeks of therapy. Conclusion: IFN treatment results in HBeAg and HBsAg loss and decreases HBV‑DNA levels in chronic hepatitis B patients. Mild to moderate adverse effects were found in intensity. So, interferon‑ therapy was well tolerated, safe, and efficacious in the treatment of HBeAg‑positive chronic hepatitis B patients without decompensated liver disease. Key words: Hepatitis B, hepatitis B virus deoxyribonucleic acid level, HBeAg‑positive

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