LONG-TERM FOLLOW-UP OF PATIENTS WITH CHRONIC HEPATITIS-C TREATED WITHDIFFERENT DOSES OF INTERFERON-ALPHA-2B

Eighty patients with chronic hepatitis C who completed a previously re ported randomized controlled trial on the efficacy of interferon-alpha 2b were followed up for at least 36 mo after therapy discontinuation. Seventeen patients (21.2%) maintained normal ALT values throughout the follow-up; 63 (78.8%) either did not normalize the levels of ALT or r elapsed during the follow-up. A significantly greater proportion of pa tients treated with 3 million units of interferon three times a week s ubcutaneously for 48 wk were long-term responders compared with patien ts treated for 24 wk. Sex, age, hepatitis C virus antibody status, sou rce of infection and pretreatment levels of ALT were not predictive of long-term response. Cirrhosis was found to be an unfavorable predicti ve factor. After 3 yr of follow-up, clearance of viremia was observed in 58.9% of the 17 long-term responders but in none of the nonresponde rs (p = 0.002). E2-NS1 antibody tested negative in 88.2% of long-term responders and in 14.3% of nonresponders (p = 0.001). Fifty-nine perce nt of long-term responders tested negative for C100-NS4 antibody compa red with 14.3% of nonresponders (p = 0.031). No significant change was observed in other antibodies. Four long-term responders underwent liv er biopsy 2 yr after discontinuation of therapy. All four patients had normal liver histology compared with baseline assessment of chronic a ctive hepatitis in three and chronic persistent hepatitis in the other . Three of the four were negative for serum hepatitis C virus RNA.