Diminished responsiveness of male homosexual chronic hepatitis B virus carriers with HTLV-III antibodies to recombinant α-interferon

✍ Scribed by J. A. McDonald; L. Caruso; P. Karayiannis; L. J. Scully; J. R. W. Harris; G. E. Forster; Professor H. C. Thomas

• Publisher: John Wiley and Sons
• Year: 1987
• Tongue: English
• Weight: 627 KB
• Volume: 7
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840070417

✦ Synopsis

In a randomized controlled trial, 41 chronic hepatitis B virus carriers were allocated, by opening numbered computerized randomization envelopes, to receive recombinant interferon-a2A at three different doses: 2.5; 5.0, and 10.0 mU per m2. Thirty-two patients received treatment (6 for 3 months, 26 for 6 months), and 9 patients were controls (received no treatment). Ninetythree per cent of our patients were homosexual, and 41% had anti-HTLV-I11 in their serum.

None of the control patients lost HBeAg. In contrast, six of the anti-HTLV-III-negative patients (33%) responded to treatment (p < 0.02): five of these responders were homosexual (p c 0.05). The response rate was greatest (44%) in the anti-HTLV-III-negative patients who received 10 mU per m2 of recombinant interferon-a2A. None of the anti-HTLV-111-positive patients responded to treatment. The percentage reduction of hepatitis B virus DNA was significantly less in the anti-HTLV-lII-positive group in comparison to the anti-HTLV-III-negative group at 1 and 4 months of treatment and at 3 months after the end of treatment (p < 0.05). These patients were younger (33 vs. 42 years, p < 0.02), had lower mean baseline AST values (42 vs. 80 IU per liter, p c 0.02) and tended to have milder histological disease.

Homosexual men with HBeAg-positive chronic liver disease who are anti-HTLV-111-positive appear to be less responsive to the direct antiviral and immunomodulatory effects of recombinant interferon-a2A. This may be due to the subclinical immunosuppressive effects of co-infection with HTLV-111.

Chronic hepatitis B virus (HBV) infection is a major health problem throughout Asia and Africa, and among "risk groups" in the developed countries. HBsAg-positive liver disease is associated with an increased risk of cirrhosis (1) and hepatocellular carcinoma (2).