Interferon treatment of chronic hepatitis C in patients cured of pediatricmalignancies

Background and Objectives. Chronic hepatitis C was a frequent complication in patients treated for malignancy until the introduction of anti-HCV scree ning tests for blood donors. The association between chronic hepatitis C an d progression to cirrhosis and hepatocellular carcinoma has been reported i n about 20% and 5% of patients, respectively, within 20-30 years of infecti on. In adult patients, interferon has proved to be effective in decreasing the abnormal values of transaminases and the level of HCV viremia, Our purp ose was to assess efficacy of and tolerance to interferon in a group of you ng patients who had acquired HCV infection during a period of chemotherapy, Design and Methods. Interferon-alpha (IFN) was administered to 26 adolescen ts and young adults (13 males, age range 17-36 years; median age 24) with c hronic hepatitis C, including 4 with hepatitis B virus co-infectiontion, wh o had been treated for leukemia or solid tumor 5 to 19 years before joining this trial. patients were i treated with natural IFN alpha at a dose of 4 MU/m(2) thrice weekly for 12 months and followed up for another 6 months th ereafter. Results. Nine patients stopped treatment during the I: first 6 months becau se of side effects (2 cases) or j lack of response, At the end of the trial , 8 (31%) cases had responded, with alanine amino-transferase normalization and clearance of hepatitis C virus (HCV) RNA. A sustained response was onl y documented in 15% of cases, however, irrespective of any hepatitis B viru s co-infection, The 2 patients with HCV genotype 2 were both responders, wh ereas only 8% of those with genotype 1 responded. interpretation and Conclusions. These data show that the efficacy of IFN in this series of young patients is similar to that reported for otherwise he althy adults with hepatitis C, Patients with genotype 2 are strong candidat es for IFN treatment while other therapeutic strategies should be designed for patients with HCV genotype 1, (C)2000, Ferrata Storti Foundation.