Effect of Adenine Arabinoside and α-Interferon in Patients with HBeAg-positive Chronic Active Hepatitis

To evaluate and compare the therapeutic efficacy of adenine arabinoside (Ara-A) and alpha-interferon (α-INF), 40 patients with biopsy proven chronic active hepatitis B were chosen at random to receive Ara-A (15 mg/Kg, iv, for 10 day) or α-INF (3 million unit, sc, every other day for 12 wks) and followed up to 12 months after completion of the therapy. All patients were HBeAg positive. The clinical effects of Ara-A and α-INF on seroconversion of HBeAg positive. The clinical effects of Ara-A and α-INF on seroconversion of HBeAg and the levels of serum aminotransferase (ALT) were closely matched and compared with those of the untreated control group (20 cases). Eighteen out of 20 patients received Ara-A, 19 patients received α-INF, and 19 out of 20 control cases were evaluated at 12 months after completion of treatment. Seroconversion of HBeAg in the α-INF treated group (19 cases) was observed in seven cases (36.8%), showing a higher seroconversion rate as compared to Ara-A-treated (2/18 cases, 11.1%) and to the control patients (1/19 cases, 5.3%). There were no effects of Ara-A on serum ALT levels in the treated patients compared with the untreated control patients. However there was a remakale drop in serum ALT levels in the INF-treated patients (p<0.005, ALT levels at 12 months after treatment; 87.4±98.8 IU/L) compared to the pretreatment levels (256.7±175.8 IU/L). The present study thus indicates that Ara-A is not recommended as the first choice of therapy in treating patients with HBeAg-positive CAH and that interferon may be recommended for those patients instead. Further study will be necessary with prolonged follow up.