212 LOW DOSES OF RECOMBINANT ALPHA 2B INTERFERON IN CHRONIC HEPATITIS B.

J.P. Coppena, Ch. Cornu* and A.P. Geubel. Department of gastroenterology and virology*, St-Luc University Hospital (UCL), 1200 Brussels, Belgium.

Since September 15th 1986, nineteen adult patients (17 caucasians) with chronic hepatitis B have been entered into an ongoing prospective trial of recombinant alpha 2b Interferon (IFN~, Intron-A--Schering corp.).

Patients : All patients had abnormal liver function tests, were HBe Ag positive and had high DNA-polymerase levels for more than six months. Patients with severe hepatic dysfunction and/or impaired cellular immunity were excluded from the trial. Pretreatment liver biopsies in 18 cases showed chronic active hepatitis (8 cases), chronic persistent hepatitis (6 cases), chronic lobular hepatitis (2 cases) and postnecrotlc cirrhosis (2 cases).

:. After. 5 "days of induction therapy wlth6increaslng doses given every day (3.10 ~, 4.100 , 5.100 units), all patients were given 5.10 units of IFN~ SC every other day for 3 months.

Results : Among 13 patients who have completed the trial, 12 showed a significative decrease in DNA polymerase levels (t=3.64, p<0.005). Early follow-up data (10+3 weeks) after completion of treatment in seven cases showed that two patients seroconverted to the anti-HBe status, one also loosing HBsAg. Among those, 4 reached undetectable levels of HBV-DNA. Two patients experienced severe side effects including thrombopenia and local allergic reaction.

Conclusions : Low doses of IFN~induce a significant reduction of viral replication in 92% of treated patients. Early follow-up data suggest that the seroconversion rate may reach more than 30%.

213 A "RARE"PIY~S~BLE MEANING OF THE ISOLATED ANTI-HBc POSITIVITY

L;Corbosiero,M.de Csprio,M.Mel ! to,E.Di Vsia-II'Div.Medicina,Osp."E.D'Aosta",USL 42,Napoli-Italy.

We well know the numerous mesnings whic~ can be given to snti-HBc positivity with contemporsry HBs Ag 8rid anti-FIBs negativity (the patients who have "lost" snti-HBs; same undergroups of present carriers; acute"window"phase). We are not quite sure about the meanings to give to an isolated anti-HBc positivity with HBc Ag and anti-HBe negativity too; in this case we have to exclude the obvious meaning of unique marker as remains of previous infec-

tion. As we h~ve found out 17 cases of isolated anti-HBc positivity(~nd HBs Ag. anti-HBs, }{Be Ag, anti-HBe negativity) with ~igh transaminase (through repeated checks up even after various months), we have subjected our patients to ~ppropristed researches. So we have noticed two cases of introhepatics markers (HBs Ag and HBc Ag) of HBv infection as well as their absence in all the other cases.(the latter have be~n subjected to resear- ches also for minor hepatitic agents: toxoplasma, rubella,CMV,EBV,Herpes- virus, coxakie virus).We have been careful to exclude pharmacological or toxic causes in general. We think we can conclude that it is probable a crossed reactivity between HBc Ag and sntigenic determinants of non A- non B viruses which are still unknown: all that in agreement with what has been supposed by other Authors.

$112