Interferon therapy for chronic viral hepatitis: Results of a Consensus Conference

During a Consensus Conference held in Bologna, Italy (June 1992), some guidelines were drawn for the treatment of chronic hepatitis B, C and D with Interferon. According to the majority of the investigators, chronic viral hepatitis B (HBeAg+ and HBeAg-) should be treated with at least 5 MU Interferon t.i.w. for 6 months. Results are considered good in HBeAg+ patients (HBV-DNA clearance and HBeAg anti-HBe+ seroconversion in 40-50% of patients treated), but disappointing in anti-HBe+, HBV-DNA patients. In both groups, relapsing patients are retreated with the same dosage and regimen by most of the participants. Patients not responding to a first cycle of IFN are usually not retreated. The vast majority of the Centres (93%) use high IFN doses (10 MU t.i.w.) for at least 12 months in chronic hepatitis D; however, response is commonly considered to be low. Retreatment of non-responders is not recommended, while a second IFN course is suggested for relapsing patients. In chronic hepatitis C, treatment should begin with 3 MU IFN t.i.w. for 3 months. For non-responders, the dose should be increased to 6 MU t.i.w.. If after 3 months ALT levels are still abnormal, treatment should be stopped. If patients relapse when therapy is withdrawn, re-treating with the initial regimen is recommended. For optimum effect, treatment has to be tailored to the patient's needs, taking into consideration: 1) the patient's age (15-65 years); 2) the stage of disease (only compensated liver disease); 3) the presence of predictive response factors (ie, low viraemia, short duration of disease).