SCHISTOSOMIASIS AS AN IMPORTANT DETERMINING FACTOR FOR THE RESPONSE OF EGYPTIAN PATIENTS WITH CHRONIC HEPATITIS-C TO THERAPY WITH RECOMBINANT HUMAN ALPHA-2 INTERFERON

The aim of the present study was to compare the response to recombinan t human alpha-2 interferon therapy in 2 groups of Egyptian patients ha ving chronic hepatitis C with or without associated schistosomiasis. G roup 1 included 36 patients with associated intestinal schistosomiasis , and group 2 included 24 patients without schistosomiasis. All patien ts had abnormal serum aminotransferase levels and were negative for he patitis B surface antigen and anti-hepatitis core antibody, but positi ve for hepatitis C virus antibody in serum. All patients received inte rferon at a dose of 3 million units subcutaneously 3 times a week for 6 months and were followed up clinically, biochemically and haematolog ically during this treatment period and for 6 months thereafter. A sec ond liver biopsy was obtained from every patient after the completion of interferon therapy. Both the percentage of complete response with r eturn to normal of alanine aminotransferase levels during therapy and the overall response rate at 6 months (when patients with a partial re sponse were also included as responders) were significantly lower (P<0 .001) in group 1 (14% and 33% respectively) than in group 2 (63% and 7 1% respectively). The liver histology also improved significantly in g roup 2 (46%) compared with group 1 (14%) after completion of therapy ( P<0.05). On the other hand the overall relapse rate in responders, by 6 months after cessation of therapy, was significantly higher (P<0.05) in group 1 (92%) than in group 2 (59%). These results show that the p resence of associated schistosomiasis has to be considered as an impor tant factor in determining the response of Egyptian patients with chro nic hepatitis C to therapy with interferon.