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Chronic hepatitis B virus infection is endemicin Asian communities in the United States. The purposeof the current study was to compare the antiviralefficacy of interferon-α2b in a groupof adult Asian patients chronically infected withhepatitis B with active replication compared to acontrol group of Caucasian patients treated with thesame regimen. Patients with entry aminotransferase (ALT)levels greater than three times the upper limit ofnormal received interferon-α2b, 5million units, subcutaneously daily for 16 weeks.Patients with pretreatment ALT levels 1.5-3 times theupper limit of normal received prednisone for a total of sixweeks prior to interferon starting at 60 mg daily withreduction in dosage by 20 mg every two weeks with atwo-week period between finishing prednisone and starting interferon-α2b. Eight(62%) of the 13 Asians and six (60%) of the 10Caucasians cleared HBeAg and HBV DNA from serum (NS). Bythe end of one year of follow-up after therapy, four(67%) of six Caucasian responders but none of the Asianresponders had cleared hepatitis B surface antigen fromserum (P < 0.05). Loss of serum markers of activereplication appeared less durable in the Asian responders compared to the Caucasians withreappearance of serum HBeAg in two (25%) of eight of theformer but only one (17%) of the latter group. Threeother Asian patients subsequently redeveloped HBeAg in serum. It is concluded that adultAsian-Americans have an identical initial response rateto antiviral therapy withinterferon-α2b; however, the responsemay be less durable and does not usually lead to loss of HBsAg.