If you are already interested in antiviral treatment with interferon, I believe you are interested in the following questions: When is the right time to use interferon antiviral therapy? It is well established that antiviral therapy is appropriate for patients with chronic hepatitis B in the immune clearance phase. The reason for this is well understood: the presence of hepatitis activity in patients with chronic hepatitis B indirectly reflects the end of the compromise between the immune system and the virus, and the body begins to “declare war” on the virus. At this time, the use of drugs is equivalent to providing “weapons and ammunition” and “long-range fire support” to one of the two sides of the fight – the immune system, so that we have more chances to win against the hepatitis B virus This gives us a better chance of winning against the hepatitis B virus. The change in ALT level is a visual indicator of the immune response in patients with chronic hepatitis B. Patients with higher ALT levels have a stronger immune response, while those with lower ALT have a weaker immune response. It has been found that patients with high levels of ALT (e.g., 2×ULN or even 5×ULN or more) and low levels of serum HBV DNA (e.g., 1×106 copies/mL or less) before treatment have better outcomes. However, the immune response of patients is too strong, and the immune response may be further enhanced during interferon therapy, which has the risk of leading to liver failure. Therefore, guidelines of relevant professional societies in China and internationally consider elevated ALT levels (2-10) × ULN as a suitable time for interferon therapy. In addition, age is considered to be an important factor affecting the efficacy of interferon, and patients younger than 40 years of age generally have better outcomes. The use of interferon in children has better efficacy than in adults and is better tolerated and safer. Antiviral therapy is necessary for children and adolescents with recurrent transaminase elevations. Interferon antiviral therapy is currently preferred, but the dose of interferon therapy must be adjusted according to body weight and monitored closely. What are the side effects of interferon antiviral therapy? Interferon has been used in the treatment of chronic hepatitis B for more than 20 years and has accumulated a lot of experience in clinical practice. Although interferon has more adverse effects, the overall listing can be controlled. As long as the treatment and monitoring are done under the guidance of doctors, the whole process is still safe. In order to better cooperate with the treatment, we must have a certain understanding of the common adverse reactions before treatment. Fever, muscle and joint pain: also known as “flu-like symptoms”, so the name, like the “flu”, fever, body aches, fatigue, reduced appetite and other symptoms, often 4 to 8 hours after the first injection, the symptoms will be significantly reduced after the second to third injection. The symptoms will be significantly reduced after the second to third injection; the severity of the reaction varies greatly from person to person, and some people may not feel anything; some people may have high fever. Generally, no special treatment is needed. For high body temperature, oral antipyretic and analgesic drugs (e.g. Loxoprofen sodium tablets, Benadryl) can lower the body temperature and relieve pain. For office workers we recommend injections on Fridays so that the weekend double break can be fully rested. Loss of appetite, nausea and other gastrointestinal symptoms: Most patients will have a reduced appetite when they first start treatment, a few patients will have nausea and rarely vomiting. It may decrease after 1 to 2 weeks of continued treatment. No special treatment is usually required. Hair loss, rash: Many people will lose their hair, just hang a lot on the comb when washing or cutting hair, but you still have beautiful hair, rarely affects beauty. Emotional and mental symptoms: manifested as a lack of interest, easily agitated, poor sleep; students will feel a lack of concentration, temporary loss of memory, etc.. Usually no special treatment is needed. A small number of patients are depressed and depressed and need to respond to a specialist. For milder cases, interferon should be reduced to continue treatment and anti-depressants can be used at the same time. Decrease in white blood cells and platelets: This is due to the myelosuppressive effect of interferon, which usually occurs in the first 2 to 3 months of treatment, with a decrease in white blood cells and platelets in about 25% to 30% of patients. Doctors will check the blood count regularly according to the situation and adjust the treatment plan according to the test results. It is still safe if you can follow the doctor’s instructions to check regularly and reflect abnormal results to the attending physician in a timely manner. Bone marrow suppression is temporary and will gradually improve as treatment continues or with appropriate adjustments, and can return to normal at the end of treatment. Hepatitis activity: As we mentioned earlier, interferon is an immune booster, which can intensify the struggle between the immune system and the virus. During the treatment process, the original hepatitis activity may increase and the transaminases may rise further, suggesting an enhanced immune response. If transaminases do not exceed 10 x ULN, they are safe. If the elevation reaches more than 10 times the upper limit of the normal value, there is a risk of jaundice and loss of liver function, so interferon should be stopped and closely monitored. Abnormal thyroid tests: Abnormalities in thyroid function markers (free T3, T4 and thyroid stimulating hormone TSH) may occur during treatment, either as a result of hyperthyroidism or reduced function. Impact on blood sugar: Although many guidelines state that patients with well-controlled diabetes can be treated with interferon, interferon can induce anti-insulin autoantibodies, which complicates the condition and greatly reduces the patient’s benefit from treatment, so personally I do not recommend treatment with interferon. The use of interferon for the treatment of chronic hepatitis B is potentially risky and may aggravate the original disease with catastrophic consequences, so it is not recommended to treat chronic hepatitis B with interferon. In conclusion, there have been more comprehensive studies on the various adverse effects of interferon, and the overall risk is manageable. Although interferon treatment generally does not require hospitalization and a very large majority of people can continue to work and go to school, patients must do the medication under the guidance of their doctor, respect the doctor’s position in the treatment process, have regular checkups, and reflect their condition in a timely manner. Good communication can be established using the “” online platform so that your doctor can keep an eye on your response to treatment. Which interferon antiviral treatment should I choose? As we mentioned earlier, there are 2 types of interferon used to treat chronic viral hepatitis: one is ordinary alpha interferon, which is injected every other day; the other is imported pegylated interferon, commonly known as “long-acting interferon”, which is injected once a week. Generally speaking, the price of ordinary interferon is between 40-80 yuan/pc, while long-acting interferon is around 1000 yuan/pc. What is the difference between these prices? The 2 types of long-acting interferons currently on the market are Pyroxin and Pellegrin. Both are linked to some biologically inactive polyethylene glycol macromolecules on ordinary interferon, making the molecular weight greatly increased, the systemic tissue interstitial distribution reduced, the kidney clearance rate reduced, so that the time in the liver and blood extended. For example, the renal clearance of Pyroxin is only 1/100 of that of ordinary interferon in one injection, and the half-life (clearance half) is 65-77 hours, and its efficacy is still well maintained after 1 week of injection, so the dosing interval can be extended to once a week.