Chronic hepatitis C is common in Saudi Arabia and most often presents
in an advanced stage. To assess the response of patients to interferon
, a randomized placebo-controlled double-blind study was undertaken. A
ll but 1 patient had cirrhosis or fibrosis before interferon. After a
24-week observation period patients received alpha 2a interferon, 3 me
ga units sc tiw or placebo for 24 weeks, then the opposite treatment f
or another 24 weeks followed by 24 weeks of observation. Liver biopsie
s were performed before and after each of the treatment phases. Twenty
-two out of 24 patients completed the study. The mean alanine aminotra
nsferase (ALT) levels fell from 150.7 +/- 118.7 units/l to 91.0 +/- 42
.6 units/l after 6 months interferon treatment (P = 0.03) but only 3 p
atients (14%) had complete normalization of mean ALT levels and 4 (18%
) had > 50% reduction. The mean hepatitis activity index fell from 12.
2 +/- 2.6 immediately before to 11.6 +/- 2.5 just after interferon (P
= 0.4). After interferon there was an insignificant raise in 6-month m
ean ALT. Hepatitis C virus-RNA was positive in all 17 patients tested
and remained so after treatment. Side-effects were mild and well toler
ated. Alpha interferon 3 mega units tiw for 24 weeks is not an effecti
ve treatment of histologically advanced chronic hepatitis C.