CHRONIC HEPATITIS-C - CLINICAL AND IMMUNOLOGICAL FEATURES AND THE EFFECT OF INTERFERON TREATMENT

Clinical and immunological findings on 74 patients with chronic hepati tis C are reported and experiences with interferon-alpha treatment of 31 patients are summarized. The transfusion history was noted in 69% o f patients and the time elapsed from the transfusion to the diagnosis was a mean of 7.15 +/- 8.1 years. Concerning the severity of the liver disease, chronic persistent hepatitis was in 40%, active hepatitis in 45% and cirrhosis in 15% of the patients. Cholestasis was recorded in 32% of the cases. A significant elevation of serum immunoglobulin lev els was noted in 83%, an antibody to liver-specific protein (anti-LSP) occurred in 80%, cryoglobulinaemia in 44% and circulating immune comp lexes in 33% of the patients. Natural killer cell activity of peripher al blood mononuclear cells significantly decreased. HLA B8 and DR3 ant igens were found with increased frequency (36.6% and 42.1%). Recombina nt interferon-alpha at a weekly dose of 3MU thrice, for six months, no rmalized serum alanine aminotransferase in 45% of patients and a susta ined remission was found in 26%. The treatment resulted in the clearan ce of HCV-RNA from the serum in 40% of patients and that correlated we ll with the complete remission. In the good responders, a decrease in CD4+ cell count and a transient decrease in CD8+ cell count as well as a moderate rise in B cell count were seen during the treatment. Mitog en-induced lymphoproliferative response and natural killer cell activi ty increased. Predictors of response were as follows. female sex, shor ter time elapsed from transfusion, absence of HLA A?, BE, DR3 and seru m anti-HBc negativity.