THE USE OF RECOMBINANT INTERFERON ALFA-2B IN ELDERLY PATIENTS WITH ANTI-HCV-POSITIVE CHRONIC ACTIVE HEPATITIS

Objective: To compare efficacy and tolerance of recombinant interferon alfa-2b in the treatment of anti-HCV-positive chronic active hepatiti s (CAH) in subjects aged 65 years and above with those less than 65. D esign: A randomized controlled trial. Setting: Outpatients in two hosp itals. Patients: 65 consecutive outpatients with anti-HCV-positive CAH for 1 to 30 years, having basal aminotransferase levels at least twic e the normal value. Those 65 and over were randomized to an interferon group (A, n = 22) or a no-treatment group (B, n = 22). All those unde r 65 received interferon (group C, n = 21). Intervention: Interferon a t a dose of 3 mU 3 times a week for a 6-month period. A normalization of serum aminotransferase levels was considered a positive response to therapy. Results: Response to therapy was positive in 62% of the trea ted elderly compared to 57% of the adults (P = 0.85). The two groups o f responders showed a common highly significant reduction of aminostra nsferase (P < 0.001). Side effects were similar in elderly and young. Two untreated elderly showed spontaneous normalization of aminotransfe rase. Conclusion: Interferon in anti-HCV-positive CAH is useful in the elderly, allowing normalization of aminotransferase, improvement of t he histology and remission of the disease in 62% of the cases. Side ef fects seem to be independent of age. Further studies are required to a ssess both duration of remission and usefulness of cyclic therapy in p revious responders.