The long-term outcome of interferon-α treated and untreated patients with HBeAg-negative chronic hepatitis B

Background/Aims: This study aimed to evaluate the effect of interferon-α therapy on the long-term outcome of HBeAg-negative chronic hepatitis B. Methods: A cohort of 209 interferon-α treated and 195 untreated patients with histologically documented HBeAg-negative chronic hepatitis B were closely followed for a mean of 6 (1–13.5) years. Patients with decompensated liver disease and/or hepatocellular carcinoma at presentation were excluded. Results: Survival and complication (liver decompensation and/or hepatocellular carcinoma) - free survival were significantly worse in patients with compared to those without baseline cirrhosis and in patients older compared to those younger than 45 years (P<10−4). Sustained biochemical remission was achieved in 57 treated patients. Sustained responders had significantly better survival and complication-free survival than non-sustained responders (P=0.027 and P=0.019, respectively) or than untreated patients (P=0.048 and P=0.012, respectively). Multivariate analysis showed that absence of baseline cirrhosis, younger age, and sustained biochemical remission were independently associated with an improved outcome. Conclusion: In patients with HBeAg-negative chronic hepatitis B, sustained biochemical remission induced by interferon-α is associated with improved long-term outcome, even in the presence of cirrhosis and old age, both known factors associated with worse survival. Therefore, long-term biochemical remission appears to represent a satisfactory therapeutic target in this setting.