Should You Get Interferon Treatment for Elevated Liver Enzymes?

Should interferon be administered?

My liver enzymes have been above 200 for about 10 months.
The liver biopsy showed an inflammation score of 2.
The doctor said it qualifies for insurance coverage.
Do I really need to start interferon treatment? I'm feeling very uncertain.
Could you please let me know quickly?

Fei Fei, 30~39 year old female. Ask Date: 2008/12/04

Dr. Li Xuanshu reply Gastroenterology and Hepatology

Hello, are you infected with Hepatitis B or Hepatitis C? Regardless of which type, your levels are quite high.
If you meet the criteria for health insurance coverage, it is advisable to pursue treatment.
You mentioned that you are concerned, but I'm not sure what specific issues you are worried about.
Feel free to call for inquiries; you can use the toll-free number 0800-000-583, where a specialist will be available to answer your questions.
Additionally, our organization has small booklets on the treatment of Hepatitis B and C, which you can request by phone.

Reply Date: 2008/12/04

More Info

When considering interferon treatment for elevated liver enzymes, particularly in the context of chronic hepatitis B, there are several factors to take into account. Elevated liver enzymes, such as ALT (alanine aminotransferase) and AST (aspartate aminotransferase), indicate liver inflammation or damage. In your case, with liver enzyme levels consistently above 200 for the past 10 months and a liver biopsy showing a moderate level of inflammation (grade 2), it is understandable that you feel uncertain about the best course of action.

Interferon therapy, particularly pegylated interferon (Peg-IFN), has been a standard treatment for chronic hepatitis B, especially for patients with active viral replication and significant liver inflammation. The goal of interferon therapy is to achieve a sustained virological response, which means that the hepatitis B virus (HBV) is suppressed to undetectable levels, and ideally, the patient may achieve seroconversion, where HBeAg (hepatitis B e antigen) becomes negative and anti-HBe (antibody to HBeAg) becomes positive. This can lead to improved liver function and reduced risk of liver complications.

However, interferon treatment is not without its challenges. It can cause significant side effects, including flu-like symptoms, fatigue, depression, and hematological changes. The decision to start interferon therapy should be based on a thorough evaluation of your overall health, liver function, and the potential benefits versus risks of treatment. Given that your liver biopsy shows moderate inflammation, it may be beneficial to consider treatment, especially if your healthcare provider believes that the potential for improvement outweighs the risks.

In terms of eligibility for treatment, you mentioned that your doctor indicated that you meet the criteria for insurance coverage. This is an important consideration, as the financial burden of treatment can be significant. If you decide to proceed with interferon therapy, it is crucial to have close monitoring of your liver function and any side effects that may arise during treatment.

Additionally, it is essential to discuss with your healthcare provider the possibility of alternative treatments. For instance, nucleos(t)ide analogs such as entecavir or tenofovir are also effective in managing chronic hepatitis B and may be better tolerated than interferon. These medications work by suppressing viral replication, which can lead to improvements in liver enzyme levels and overall liver health without the side effects associated with interferon.

Ultimately, the decision to initiate interferon therapy should be made collaboratively with your healthcare provider, considering your specific circumstances, preferences, and the potential impact on your quality of life. If you are feeling overwhelmed or uncertain, seeking a second opinion from a hepatologist or a specialist in liver diseases may provide additional insights and help you make a more informed decision.

In summary, while interferon treatment can be effective for elevated liver enzymes in chronic hepatitis B, it is essential to weigh the benefits against the potential side effects and consider alternative therapies. Regular follow-ups and monitoring will be crucial in managing your condition effectively.

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