A. Cecere et al., Lymphoblastoid alpha-IFN, leukocytic alpha-IFN and natural beta-IFN in thetreatment of chronic hepatitis C: a clinical comparison of 150 cases, HEPATOL RES, 15(3), 1999, pp. 225-237
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.