Lymphoblastoid alpha-IFN, leukocytic alpha-IFN and natural beta-IFN in thetreatment of chronic hepatitis C: a clinical comparison of 150 cases

A randomized clinical trial was performed on 150 patients with chronic hepa titis C in order to evaluate the efficacy and tolerability of three differe nt types of interferon (lymphoblastoid alpha-IFN, leukocytic alpha-IFN and natural beta-IFN). Serum ALT levels serum HCV RNA levels, HCV genotypes and liver histology were assessed. After 12 months of therapy, normalization o f ALT levels was observed in 76% of patients treated with lymphoblastoid al pha-IFN (group 1), 64% of patients treated with leukocytic alpha-IFN (group 2) and 52% of patients treated with beta-IFN (group 3). At the end of a 6- month follow-up period, the proportion of sustained responses was higher in group 1 compared with group 2 (32 vs 22%, P = NS) and close to significanc e compared with group 3 (32 vs 16%, P = 0.06). The biochemical response was generally associated with the virological (negativization of HCV RNA) and histological responses. At the end of the treatment period, the histologica l picture was significantly improved in patients with normal ALT levels. A similar improvement in liver histology was also observed in those patients who did not respond to treatment, regardless of the type of IFN used. The H CV genotypes most frequently detected were Ib and 2a/2b; 2a/2b showed the b est response to IFN therapy; 1b showed the poorest response. However, lymph oblastoid alpha-IFN produced higher protracted response rates in patients w ith genotype 1b infection. In conclusion, lymphoblastoid alpha-IFN increase s the proportion of long-term responses and improves histology at least for 6 months following treatment. Considering the lower rate of side effects o bserved with leukocytic alpha-IFN and beta-IFN, further studies aimed at im proving their clinical efficacy (higher doses, daily or prolonged schedules of treatment, etc.) should be addressed, (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.