HUMAN-LEUKOCYTE INTERFERON-ALPHA IN CHRONIC HEPATITIS-C RESISTANT TO RECOMBINANT OR LYMPHOBLASTOID INTERFERON-ALPHA - A RANDOMIZED CONTROLLED TRIAL

Patients with biopsy-proven chronic hepatitis C, who failed to respond to a previous course of either recombinant (rIFN-alpha) or lymphoblas toid (LyIFN-alpha) interferon-alpha, were randomized to receive either leucocyte (Le) IFN-alpha (patients) or a second course of the same IF N-alpha (controls), to compare the efficacy and safety of these treatm ent schedules. All patients received the same dose of IFN-alpha as was used during their previous treatment (3 million units (MU) or 6 MU th ree times weekly) for 6 months, Patients with a normal alanine aminotr ansferase (ALT) value at month 6 were treated for a further 6 months. All patients were followed-up for 12 months after treatment. A total o f 69 patients were enrolled, 44 in the LeIFN-alpha group and 25 in the control group, At the end of the treatment period, 13 of the 44 patie nts (29.5%) in the LeIFN-alpha group had a biochemical response (norma l ALT) and six of 44 (13.6%) patients had undetectable serum hepatitis C virus (HCV) RNA. At the end of the follow-up period, 10 patients (2 2.7%) had normal ALT values and serum HCV RNA was undetectable in thre e (6.8%). None of the patients in the control group showed normal ALT values at any time. Genotype 1b tended to be more frequent among non-r esponders (61 vs 45%); basal gamma-glutamyl transpeptidase (gamma-GT) values were lower in responders than in non-responders (33.3 +/- 11.70 U l(-1) vs 58.4 +/- 33.04; P = 0.01). LeIFN-alpha was well tolerated by all patients. These results support the use of LeIFN-alpha in patie nts with chronic hepatitis C who are non-responders to a previous trea tment with recombinant or lymphoblastoid IFN-alpha.