Gastroenterology Book

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Interferon alfa

Aka: Interferon alfa, Interferon-alfa
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  1. Mechanism
    1. Inhibits viral replication in virus infected cells
  2. Indications
    1. Hepatitis C
    2. Hepatitis B
  3. Dosing
    1. Dose: 3 MU SQ three times per week for 6-12 months
  4. Efficacy
    1. Sustained response in 10-30% of cases
    2. Improved response rates with:
      1. Low levels of Viremia
      2. Absence of Cirrhosis
      3. Absence of Hepatitis C genotype Ib
      4. Early response to interferon
      5. Low total body iron
    3. Synergistic effect when combined with Ribavirin
  5. Adverse Effects
    1. Transient Flu-like symptoms (>50%)
      1. Fever and chills
      2. Headache
      3. Myalgia
      4. Nausea
      5. Diarrhea
    2. Initial: Decreased cell lines
      1. Decreased Granulocytes
      2. Thrombocytopenia
    3. Later
      1. Fatigue
      2. Major Depression
      3. Alopecia
      4. Rash
      5. Retinal Hemorrhages
      6. Autoimmune Thyroid disease
  6. Management of adverse effects
    1. Initial flu-like symptoms
      1. Acetaminophen (Tylenol)
    2. Hemolytic Anemia
      1. Decrease dosage or discontinue interferon
  7. Monitoring: Discontinue interferon criteria
    1. Liver Function Tests not normalized by 12 weeks
  8. References
    1. Lau (1997) Gastroenterology 113:1660-7
    2. (1999) Med Lett Drugs Ther 41(1054):53-4

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