LONG-TERM CARRIAGE OF HEPATITIS-C VIRUS WITH NORMAL AMINOTRANSFERASE AFTER INTERFERON TREATMENT IN PATIENTS WITH CHRONIC HEPATITIS-C

Studies were undertaken to investigate whether interferon therapy coul d induce hepatitis C virus (HCV) carriage with normal serum alanine am inotransferase (ALT) values using an assay that combined reverse trans cription and polymerase chain reaction. The subjects studied were 53 p atients with chronic active hepatitis C who received interferon (alpha , 33 cases; beta, 20 cases) therapy. All were seropositive for HCV RNA prior to therapy. In all 22 complete responders, whose ALT levels fel l to normal during therapy and for at least 24 weeks after therapy, HC V RNA became persistently negative except in two cases. The two had su stained viremia on treatment and for 1.0-1.5 years of follow-up, altho ugh their biochemical tests were normal. In 15 patients with a transie nt response in whom the disease recurred when interferon was stopped, HCV RNA was undetectable in 80% of the cases at the end of therapy, bu t the virus reappeared with subsequent elevation of ALT in all patient s. However, 3 patients in this group had normal enzyme levels with vir emia for 2.1-2.8 years of follow-up after acute deterioration of illne ss. In 16 patients who did not respond to interferon, HCV RNA was pers istently positive during and after therapy. These findings suggest tha t interferon therapy induces a long-term carrier state of HCV infectio n with normal ALT levels in some patients. (C) 1993 Wiley-Liss, Inc.