AN INTERMEDIATE-DOSE OF ALPHA-RECOMBINANT INTERFERON-2A FOR CHRONIC HEPATITIS-C WITH NONSEVERE HISTOLOGICAL PATTERN

In the light of recent research, which suggests an interferon (IFN) th erapy schedule on the basis of single patient characteristics (e.g. hi stological pattern, viral genotype) and the cost/benefits of such ther apy, we studied the efficacy and tolerability of an intermediate dose (4.5MU 3 times a week) of alpha-recombinant interferon-2a (alpha-r IFN -2a) in 28 patients with histologically proven chronic hepatitis C, 20 were hepatitis C virus (HCV)-RNA+ve, 5 were HCV-RNA-ve, and in 3 pati ents HCV-RNA status was not carried out. The viral genotypes were: 13 (65%) 1b, 2 (10%) 1a, 1 (5%) 1a + 1b, 3 (15%) 2a, 1 (5%) 3a; histologi cal pattern: 21 (75%) mild chronic active hepatitis (CAH), 7 (25%) mod erate CAH. 4.5MU of alpha-r IFN-2a were given 3 times a week for 6 mon ths, followed by 3MU 3 times a week for 6 months. Six patients (21.4%) had a biochemical and virological sustained response (SR), 8 patients (28%) had ALT normalisation during therapy (transient complete respon se [TCR]) followed by relapse, 3 patients (10.7%) had a TCR with break through (BT), 4 patients (14.3%) had a partial response (PR) and 7 pat ients (25%) were nonresponders (NR). We observed persistent HCV-RNA se rum loss in all patients with SR, transient HCV-RNA serum loss in 8 pa tients with TCR, TCR and BT and PR; in 5 patients who were NR no HCV-R NA serum loss occurred. The prevalence of HCV genotype 1b and the dura tion of disease in SR and NR groups showed a significant difference. M oreover, we found a significant correlation between prevalence of HCV genotype 1b and type of response (r=0.899, p < 0.05) between mean age in the different patient groups and prevalence of HCV genotype 1b(r=0. 881, p < 0.05), and between disease duration and type of response (r=0 .874, p < 0.05). The schedule we used can be considered as well tolera ted and efficacious at least in chronic hepatitis C with nonsevere his tological pattern, with an HCV genotype other than 1b.