INTERFERON-ALPHA FOR THE TREATMENT OF CHRONIC HEPATITIS-C IN PATIENTSINFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

Liver disease secondary to hepatitis C virus (HCV) infection is a risi ng cause of morbidity and mortality among individuals who have been in fected parenterally with human immunodeficiency virus (HIV) such as in jection drug users, hemophiliacs, and transfused patients. We analyzed both the efficacy of interferon (IFN) cu therapy in these patients an d the predictors of response to this agent. A total of 119 patients wi th chronic hepatitis C (90 of whom were infected with HIV and 29 of wh om were not) were included in a multicenter, prospective, open, nonran domized observational study. IFN-alpha was given subcutaneously in a d osage of 5 million units three times a week during a 3-month period; t hose patients who responded received a dose of 3 million units given s ubcutaneously three times a week for an additional 9 months. One hundr ed seven patients completed the study; the level of aminotransferases returned to normal and sera became negative (complete response) for HC V RNA in 26 (32.5%) of 80 HIV-infected patients and 10 (37.0%) of 27 n on-HIV-infected patients (P = .666) after completion of the treatment. Two variables were independently associated with a response in HIV-in fected patients: a CD4(+) T lymphocyte count of > 500 x 10(6)/L and a baseline HCV viremia level of < 10(7) copies/mL. In the 12 months foll owing treatment, relapses occurred in 30.8% of the HIV-infected patien ts and 12.5% of non-HIV-infected patients (P = .403).