Meta-analysis Shows Interferon Reduces Progression to Cirrhosis and Liver Cancer in People with Chronic Hepatitis B

By Liz Highleyman

Over time, chronic hepatitis B virus (HBV) infection can progress to advanced liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). As reported in the April 2009 Journal of Viral Hepatitis, Chinese researchers conducted a meta-analysis of available literature to evaluate whether interferon reduces the incidence of liver cirrhosis and HCC in patients with chronic hepatitis B.

Interferon -- either conventional interferon alfa-2b (Intron A) or pegylated interferon alfa-2a (Pegasys) -- is approved therapy for chronic hepatitis B in the U.S., along with several oral nucleoside/nucleotide analog agents.

Interferon has been used in the treatment of chronic hepatitis B for decades, the authors noted as background. Beneficial effects including hepatitis B "e" antigen (HBeAg) clearance and HBV DNA suppression have been documented, but whether treatment helps prevent cirrhosis and liver cancer is not clear.

The investigators identified 12 controlled clinical trials -- with a combined total of 2082 participants -- that compared interferon versus no treatment. Of these, 5 studies including data on development of cirrhosis and 11 including data on development of HCC were analyzed.

Data on the incidence of liver cirrhosis and HCC in interferon-treated and untreated patients were extracted from each study. Evaluation of preventive effectiveness was performed using an intention-to-treat method. The researchers detected no evidence of publication bias, the tendency to preferentially publish studies that yield positive results.

The authors observed a different incidence of liver cirrhosis and HCC between interferon-treated and untreated patients. The relative risk of cirrhosis was 0.65 and the relative risk of HCC was 0.59.

In conclusion, the investigators wrote, "the results of this meta-analysis indicate that interferon prevents or delays the development of liver cirrhosis and HCC in patients with chronic hepatitis B."

4/3/09

Reference
YF Yang, W Zhao, YD Zhong, and others. Interferon therapy in chronic hepatitis B reduces progression to cirrhosis and hepatocellular carcinoma: a meta-analysis. Journal of Viral Hepatitis 16(4): 265-271. April 2009. (Abstract).