Abstract
Acute hepatitis C takes a chronic course in 50–80% of cases. Results with interferon treatment are conflicting. To evaluate the efficacy of high-dose interferon treatment, we initiated a pilot study in 1992 using 10 MU interferon-α2b administered subcutaneously daily until normalization of serum transaminase concentrations. Treatment was begun when a diagnosis of acute hepatitis C was established. HCV-RNA was tested using PCR prior to treatment, three times weekly during the first two weeks of treatment, and then once weekly until the end of therapy. During the 15-month follow-up, HCV-RNA tests were performed monthly up to month 6 and every two to three months thereafter. Twenty-four patients were enrolled at the time of writing; age ranged from 18 to 76 years (mean=32), and nine patients were men. All patients presented with cholestatic hepatitis; 19 were actively abusing intravenous drugs, four had no known parenteral exposure, and one was a medical laboratory technician. All patients were anti-HCV positive, HCV-RNA positive, and HIV negative. Five patients were infected with genotype 3, five with genotype 1a, five with genotype 1b, three with genotypes 3 and 2, and one with genotypes 1 and 2. All patients exhibited normalized serum transaminase concentrations within 18–43 days; HCV-RNA became negative in all patients within 4–12 days. Toxicity did not exceed grade 1 and disappeared within three days of treatment. In the follow-up period, which ranged from six to 29 months (mean=19.5±10.4), serum ALT concentrations remained normal and HCV-RNA remained negative in all patients except two dropouts and two patients who developed relapsing disease after having been HCV-RNA negative for three and eight months, respectively. In both patients, the same HCV genotype 3 reemerged. Serum ALT concentrations ranged from 531 to 1940 IU/liter (mean=1055; normal <22). Concentrations of HCV-RNA (Quantiplex; Chiron, Emeryville, California) were <3.5×105 eq/ml in nine of 14 PCR-positive patients. In the other five patients, concentrations ranged from 10.4×105 eq/ml to 131.6×105 eq/ml (mean=69.6×105). No correlation was observed between HCV-RNA concentrations and serum ALT concentrations at presentation (r=0.331;P=0.67) and total dose of interferon-α2b administered until normalization of ALT (r=−0.088;P=0.74). Twenty-two of 24 patients completed treatment (two were noncompliant). Of these, 20 achieved a complete response (HCV-RNA negative for at least six months). Two of these patients relapsed, and 18 (90%) remained HCV-RNA negative for 18.65 (±9.7) months. These findings suggest that high-dose interferon-α2b is well tolerated and effective in preventing a chronic course of hepatitis C infection.
Article PDF
Similar content being viewed by others
References
Esteban R: Is there a role for interferon in acute viral hepatitis? Gut 34(suppl 2):S77-S80, 1993
Barrera JM, Bruguera M, Ercilla MG, Gil C, Celis R, Gil MP, del Valle Onorato M, Rodés J, Ordinas A: Persistent hepatitis C viremia after acute self-limiting posttransfusion hepatitis C. Hepatology 21:639–644, 1995
Alter MJ, Mast EE: The epidemiology of viral hepatitis in the United States. Gastroenterol Clin North Am 23:437–455, 1994
Alberti A, Chemello L, Benvegnú L: Pilot study of interferon alpha-2a in preventing chronic evolution of acute hepatitis C.In Viral Hepatitis and Liver Disease. FB Hollinger, S Lemon, H Margolis (eds). Baltimore, Williams and Wilkins, 1992
Viladomiu L, Genescà J, Esteban JI, Allende H, González A, López-Talavera JC, Esteban R, Guardia J: Interferon-α in acute posttransfusion hepatitis C: A randomized, controlled trial. Hepatology 15:767–769, 1992
Lampertico P, Rumi M, Romeo R, Craxì A, Soffredini R, Biassioni D, Colombo M: A multicenter randomized controlled trial of recombinant interferon-α2b in patients with acute transfusion-associated hepatitis C. Hepatology 19:19–22, 1994
Omata M, Yokosuka O, Takano S, Kato N, Hosoda K, Imazeki F, Toda M, Ito Y, Ohto M: Resolution of acute hepatitis C after therapy with natural beta interferon. Lancet 338:914–915, 1991
Takano S, Satomura Y, Omata M, and Japan Acute Hepatitis Cooperative Study Group: Effects of interferon beta on non-A, non-B acute hepatitis: A prospective, randomized, controlled-dose study. Gastroenterology 107:805–811, 1994
Koenig P, Vogel W, Umlauft F, Weyrer K, Prommegger R, Lhotta K, Neyer U, Stummvoll H-K, Gruenewald K: Interferon treatment for chronic hepatitis C virus infection in uremic patients. Kidney Int 45:1507–1509, 1994
Bradley DW, Krawczynski K, Ebert JW, McCaustland KA, Choo Q-L, Houghton MA, Kuo G: Parenterally transmitted non-A, non-B hepatitis: Virus-specific antibody response patterns in hepatitis C virus-infected chimpanzees. Gastroenterology 99:1054–1060, 1990
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vogel, W., Graziadei, I., Umlauft, F. et al. High-dose interferon-α2b treatment prevents chronicity in acute hepatitis C. Digest Dis Sci 41 (Suppl 12), 81S–85S (1996). https://doi.org/10.1007/BF02087880
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02087880