EFFICACY AND SAFETY OF ALPHA-INTERFERON TREATMENT FOR CHRONIC HEPATITIS-C IN HIV-INFECTED PATIENTS

The efficacy and safety of recombinant alpha-interferon (IFN) therapy for chronic hepatitis C (CHC) was assessed in 57 HIV-infected individu als with CD4(+) T cells above 200/mm(3) and compared to the response o btained in 21 HIV-negative patients with CHC. IFN 5 megaU was given th ree times a week subcutaneously for 3 months. In responding patients, IFN 3 megaU three times a week was additionally administered for 9 mon ths. After 8 months follow-up in HIV-infected patients, 38% (22/57) ac hieved normal (complete response, CR) alanine aminotransferase (ALT) v alues. Partial response (PR) was seen in 21% (12/57), and 40% (23/57) did not respond. Patients with CD4(+) cells above 500/mm(3) achieved C R in 58% (14/24) of cases compared to 24% (8/33) among those having a lower CD4(+) count (P<0.07). Females attained CR in 60% (9/15) of case s, and men in only 30.9% (13/42) (P<0.01). No ser ions side effects or opportunistic infections were observed during the study period. Howev er, three (5.2%) patients showed a dramatic fall in total CD4(+) T cel l count after beginning IFN therapy. Among 21 HIV-negative patients, a fter 8 months follow-up, CR was achieved in 10 (47%), PR in four (19%) , and seven (33%) did not respond. We concluded that IFN therapy seems to be well tolerated and useful in HIV-infected patients suffering CH C. The rate of CR was not significantly different compared to that obs erved in HIV-negative patients (38% vs. 47%), relative risk (RR) = 0.6 7 (0.19-2.37). However, in HIV-positive patients, a lack of response t o IFN therapy was particularly associated with a CD4(+) cell count low er than 500/mm(3) (only 24% achieved CR) compared to the response obta ined in patients with CD4(+) count above 500/mm(3) (CR was seen in 58% ) (P<0.01). The Effect of IFN therapy on CD4 + T cells needs to be cla rified in these patients.