Interferon therapy in haemodialysis patients with acute hepatitis C virus infection and factors that predict response to treatment

In view of the high rate of chronicity of acute hepatitis C and the low eff icacy of interferon (IFN) treatment in advanced liver disease, it may be be neficial to treat patients during the acute phase of the infection. Here we assessed the effects of variable-dose IFN alpha -2b treatment in haemodial ysis patients with acute hepatitis C virus (HCV) infection, and identified factors that may predict response to this therapy. The study population inc luded 67 patients, but 14 were excluded due to side-effects or because they were lost to follow-up. Seventeen patients who received no specific treatm ent were used as controls (Group 1). Sixteen and 20 patients received low-( 3 MU) and high-dose (6-10 MU) IFN alpha -2b three times weekly for 3 months (Groups 2 and 3, respectively). Virological end-of-treatment response (ETR ) was observed in 1 (5.6%), 13 (56.5%), and 17 (65.4%) patients in Groups 1 , 2, and 3, respectively, and virological sustained response (SR) was obser ved in 1 (5.6%), 6 (26.1%), and 13 (50%) patients in the three groups. The rates of virological ETR and SR in the treated groups were significantly hi gher than those of the control group (P < 0.01 for all comparisons). In mul tivariate logistic regression analysis, single stranded confirmational poly morphysm (SSCP) band number (P=0.02) was the only factor that was significa ntly associated with virological SR. In conclusion, IFN-alpha treatment ini tiated during the acute phase of HCV infection is associated with a higher rate of virological ETR and SR. This study suggested that quasispecies hete rogeneity has predictive value with regard to virological SR.