Complete response to twice-a-day interferon-beta with standard interferon-alpha therapy in acute hepatitis C after a needle-stick

A 25-year-old male physician with acute hepatitis C after needle-stick inju ry was treated with combination therapy including twice-a-day interferon-be ta (IFN-P) and standard interferon-alpha (IFN-alpha). The infecting strain was of genotype Ib. Pretreatment hepatitis C virus (HCV) RNA levels were hi gh. Because severe paresthesias occurred with initial daily administration of 5 million units (MU) of lymphoblastoid IFN-alpha, the dose was reduced t o 3 to 6 MU of IFN-alpha 2b three times a week. However, HCV RNA was not cl eared from serum after 20 weeks of standard IFN-alpha 2b treatment. A Lf-we ek course with IFN-beta, at the dosage of 3 MU twice daily TV drip, was the n started and followed by an Is-week course with IFN-a2b, 6 MU thrice weekl y. After IFN-beta treatment, HCV RNA was cleared from serum without severe adverse effects, including paresthesias. Total amounts of IFN administered were 20 MU of lymphoblastoid IFN-alpha, 648 MU of IFN-alpha 2b, and 252 MU of IFN-P. Complete response and avoidance of chronic HCV infection were ach ieved. Thus, combination therapy with twice-a-day IFN-beta and standard IFN -alpha was effective in treating an acute hepatitis C patient with a high v iral load and sensitivity to adverse effects of high-dose IFN-alpha.