POSTTRANSFUSION ETIOLOGY AND NONCIRRHOTIC HISTOLOGY IMPROVE THE REMISSION RATE OF CHRONIC HEPATITIS-C DURING INTERFERON TREATMENT

During a 29 month period, 46 patients with chronic hepatitis C virus ( HCV) received recombinant human interferon alpha-2a for 6 months and w ere followed for another 6 months. The dose of interferon was three mi llion units thrice weekly and was increased to six million units if am ino transferase levels failed to return to normal after 2 months of th erapy. At the end of the treatment 19 patients had a complete response , 6 had a near complete response, 2 patients had breakthrough during t reatment, and the remaining 19 did not respond at all. Six months afte r treatment only 10 of the 19 responders remained in remission. Post-t ransfusion disease was associated with a significantly higher remissio n rate than sporadic disease (9/22 vs. 1/24, P <0.001), as was also fo und in non-cirrhotic compared to cirrhotic patients (9/27 vs. 1/19, P <0.001). Age, sex, duration of disease, serum aminotransferase, albumi n, bilirubin, alkaline phosphatase, or Child's classification did not correlate with treatment response. Severe side effects necessitating c essation of treatment occurred in six patients, four of whom had major autoimmune phenomena. We conclude that careful selection of HCV patie nts with favorable response characteristics (post-transfusion etiology and non-cirrhotic liver) and without autoimmune manifestations can im prove the remission rate and decrease the complication rate during int erferon treatment.