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) therapy schedule on the basis of single patient characteristics (e.g. histological pattern, viral genotype) and the cost/benefits of such therapy, we studied the efficacy and tolerability of an intermediate dose (4.5MU 3 times a week) of alpha-recombinant interferon-2a (α-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 patients 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; histological pattern: 21 (75%) mild chronic active hepatitis (CAH), 7 (25%) moderate CAH. 4.5MU of α-r IFN-2a were given 3 times a week for 6 months, 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 response [TCR]) followed by relapse, 3 patients (10.7%) had a TCR with breakthrough (BT), 4 patients (14.3%) had a partial response (PR) and 7 patients (25%) were nonresponders (NR). We observed persistent HCV-RNA serum loss in all patients with SR, transient HCV-RNA serum loss in 8 patients with TCR, TCR with BT and PR; in 5 patients who were NR no HCV-RNA serum loss occurred. The prevalence of HCV genotype 1b and the duration of disease in SR and NR groups showed a significant difference. Moreover, 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 response 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 tolerated and efficacious at least in chronic hepatitis C with nonsevere histological pattern, with an HCV genotype other than 1b.