CHRONIC HEPATITIS-C LONG-TERM RESPONDERS TO HUMAN-LEUKOCYTE INTERFERON-ALPHA THERAPY - PERSISTENCE OF A SUSTAINED BIOCHEMICAL AND VIROLOGICAL RESPONSE DURING 5 YEARS OF SURVEILLANCE

Objectives To define the biochemical and virological course and IgM re sponse to HCV-core protein in longterm responders (LTRs) during a long surveillance (5 years). Design From 1989 to 1991, 98 patients (pts) w ith biopsy-proven chronic hepatitis C were enrolled into this study. T hese pts underwent human leukocyte interferon-alpha (LE-IFN alpha) the rapy at the prolonged schedule (3 MU thrice weekly for 1 year), Method s Serum alanine-aminotransferases (ALTs) were assessed monthly during and until 1 year after treatment, then every 3 months during the obser vation period. Qualitative and quantitative HCV RNA and HCV IgM were m easured in all pts on baseline samples and in LTRs also after treatmen t and every following year, Results Based on serum ALT course, the pts were defined as: LTRs (14 pts), if their serum ALT levels returned to the normal range during therapy and remained so for at least 1 year a fterwards; responders with relapse (RRs, 20 pts), if their serum ALT l evels returned to the normal range during therapy but increased after ending treatment; and non-responders (NRs, 64 pts), if their serum ALT levels remained abnormal throughout therapy. No significant differenc es were seen regarding IgM anti-HCV positivity and serum ALT levels am ong the three groups, LTRs (12 HCV-RNA negative and two HCV-RNA positi ve at the end of treatment) maintained their virological status and no t one of them experienced an elevation of serum ALT levels throughout the surveillance. Conclusion Patients affected by chronic hepatitis C and treated with interferon, but who did not experience a biochemical or virological relapse within the first year of follow-up would not re lapse later on; thus, we are able to conclude that these subjects made a complete recovery. (C) 1998 Lippincott-Raven Publishers.