A COMPARISON OF 4 TYPES OF INTERFERON-ALPHA IN THE TREATMENT OF CHRONIC HEPATITIS-C

Several clinical trials and mete-analyses have shown that the efficacy of interferon (IFN)-alpha in the treatment of chronic hepatitis C is variable, depending on the type of IFN-alpha used. We randomly assigne d 220 patients with hepatitis C to receive a B-month treatment (3 mega units three times per week) with lymphoblastoid IFN-alpha (group A), r ecombinant IFN alpha-2a (group B), leukocyte IFN-alpha (group C), or r ecombinant IFN alpha-ab (group D). The groups were homogeneous with re ference to histologic severity of the disease (chronic persistent hepa titis, 21.4%; mild chronic active hepatitis, 28.2%; moderate chronic a ctive hepatitis, 28.6%; and severe chronic active hepatitis, 21.8%). W e used common laboratory techniques to detect and assess all serum var iables. Liver biopsy was conducted according to Menghini's modified te chnique, and administration of IFN alpha was conducted according to a double-masked method. A total of 220 patients mere enrolled in tile st udy. Ninety-two patients dropped out because of side effects, comorbid ity unrelated to the baseline disease, or voluntary termination and 12 8 patients (32 patients in each group) completed the treatment course and the follow-up period. At the 6-month end point, 14 of 32 patients mere complete responders in group A, 13 of 32 in group B, 14 of 32 in group C, and 8 of 32 in group D. After completion of the follow-up per iod, 10 of 32 patients had a sustained response in group A, 9 of 32 in group B, 10 of 32 in group C, and 8 of 32 in group D. Treatment failu re and relapse rates mere higher in the patients treated with recombin ant alpha IFNs than in patients treated with leukocyte or lymphoblasto id IFN alpha. We observed no relation between the relapse rate and bas eline severity of the disease. Among the recombinant IFNs, a major rat e of clinical response was observed in patients treated with recombina nt IFN alpha-as. Although leukocyte IFN-alpha and lymphoblastoid IFN-a lpha treatments showed an overlapping efficacy in terms of complete or sustained response, the former achieved a lower rate of treatment fai lure or relapse.