ALPHA-INTERFERON FOR HEPATITIS-C VIRUS-INFECTION IN HEMOPHILIC PATIENTS

We have conducted a controlled trial in 20 haemophilic patients in whi ch intravenous recombinant interferon alpha-2a, 3 mega units thrice we ekly, was used to treat chronic hepatitis C infection. The study endpo ints included complete and partial normalization of serum ALT, and los s of serum HCV RNA as determined by polymerase chain reaction (PCR). I nterferon treatment was effective, and resulted in improvement in;ALT in nine (45%) and a loss of HCV RNA in five patients (26%), but a sust ained normalization of ALT has been seen in only one case. Responses w ere poor in those with HIV coinfection or with HCV genotype 1 (Simmond s classification). Troublesome side-effects were reported in 80%. The occurrence of a factor VIIIc inhibitor during the study was possibly a n autoimmune complication of interferon. In conclusion, we have shown lower response rates than those seen in post-transfusion hepatitis C i nfection and suspect that current interferon regimes are unlikely to i nfluence the natural history of HCV infection in haemophilia. Consider ation should be given to trials of higher dosage interferon, and of lo ng-term maintenance therapy for those who relapse.