EFFICACY AND SAFETY OF INTERFERON-ALFA THERAPY IN CHRONIC HEPATITIS-CWITH AUTOANTIBODIES TO LIVER-KIDNEY MICROSOMES

Interferon alfa (IFN) therapy is efficacious in chronic viral. hepatit ides. It may, however, cause adverse immunologic reactions in patients with concomitant autoimmune phenomena. A minority of patients with ch ronic type C hepatitis have antibodies against liver and kidney micros omes (anti-LKM) in serum. We therefore carried out this study to find out whether IFN is safe and efficacious also in this subgroup. We trea ted 92 consecutive cases of chronic hepatitis C with IFN. Twelve patie nts had anti-LKM, and the remaining 80 tested negative to the anti-LKM . The hepatitis C virus (HCV) infection was diagnosed on the basis of positive anti-HCV and HCV-RNA tests. We compared the clinical and viro logical results of the therapy and the side effects found in the two g roups. We found that the response to therapy and the outcome after 1 y ear of follow-up were similar. Treatment was discontinued in one anti- LKM-positive patient because of a drastic increase in ALT levels at th e fourth month of therapy. No untoward effect was observed in the othe r cases. Hepatitis C patients with anti-LKM may be exposed to an incre ased risk of an adverse hepatitic reaction while being treated with HN However, we found that the extent of the risk was minimal compared wi th the expected benefits of the therapy. IFN is therefore recommended as the first therapy to choose in these patients. They must, however, be monitored more closely for possible Liver dysfunction than the ordi nary hepatitis C patient.