INTERFERON-ALFA THERAPY IN PATIENTS WITH CHRONIC HEPATITIS-C AND PERSISTENTLY NORMAL AMINOTRANSFERASE ACTIVITY

Background & Aims: Chronic hepatitis C virus carriers may have repeate dly normal aminotransferase activity despite detectable viremia and hi stological hepatitis. The aim of this study was to determine the effec t of interferon in this population, Methods: Three million units of in terferon alfa was administered 3 times weekly for 6 months in 10 patie nts with chronic hepatitis C virus infection, repeatedly normal alanin e aminotransferase activity, and chronic hepatitis on liver biopsy, Se rum hepatitis C virus RNA was detected by polymerase chain reaction an d quantified by branched DNA before, at the end, and 1 year after trea tment. A liver biopsy was performed 1 year after treatment withdrawal, Results: At treatment withdrawal, hepatitis C virus RNA levels had si gnificantly decreased, but RNA was still detectable by polymerase chai n reaction in 8 of 10 patients, During the 1-year follow-up period, 6 of 9 patients had elevated aminotransferase activity on at least one o ccasion, One year after treatment withdrawal, RNA levels had returned to pretreatment values and no significant histological improvement was observed in the 7 patients who underwent liver biopsy. Conclusions: I n patients with chronic hepatitis C and repeatedly normal aminotransfe rase activity, standard interferon therapy does not lead to sustained virological or histological responses despite a transient effect on he patitis C virus replication.