Long-term antifibrotic action of interferon-γ treatment in patients with chronic hepatitis B virus infection

BackgroundThe first priority in treating fibrosis is to eliminate the causes that result in liver injury, e.g., hepatitis B and C virus. However, in many liver diseases the cause is either unknown or untreatable. The present study was designed to investigate the long-term antifibrotic effect of interferon-gamma (IFN-γ) treatment in patients chronically infected with hepatitis B virus.MethodsA total of 42 patients, 30 treated with IFN-γ and 12 controls, were enrolled from an original clinical trial (Clin Gastroenterol Hepatol 2005;3:819.). Three serial liver biopsies that were obtained at the initiation and end of IFN-γ treatment as well as 4 to 6 years after treatment discontinuation were assessed according to the modified Chevallier scoring system.ResultsTwenty-five out of 30 IFN-γ-treated patients were followed up until 4 to 6 years after the treatment was stopped. However, all controls were excluded from follow-up due to death, loss and elevated virus level within 2 years. Twenty-five IFN-γ-treated patients had stable serum liver function and liver fibrosis indices without any further anti-viral or antifibrotic treatment. Improved inflammatory and fibrotic scores were found after nine months of IFN-γ treatment according to the modified Chevallier scoring system (inflammation: 11.8±6.5 at the beginning of IFN-γ treatment vs. 9.2±4.1 after 9 months, P<0.05; fibrosis: 15.0±7.3 at baseline vs. 12.6±6.8 after 9 months, P<0.05). Among them, 14 patients accepted a third serial liver biopsy 4 to 6 years after treatment discontinuation, and the fibrotic score was increased (14.2±8.3 vs. 11.9±7.6 after 9 months, P<0.05).ConclusionsNine-month IFN-γ treatment significantly improves the fibrosis score in patients with chronic HBV infection. The majority of patients demonstrate stable serum biochemical indices and quality of life. However, they do not show a long-term benefit according to histological criteria. Given the limited sample size, long-term IFN-γ treatment regimens should be assessed in further clinical trials.