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Interferon alfa treatment of HCV RNA carriers with persistently normal transaminase levels: A pilot randomized controlled study
Author(s) -
Sangiovanni Angelo,
Morales Rino,
Spinzi GianCarlo,
Rumi MariaGrazia,
Casiraghi Antonietta,
Ceriani Roberto,
Colombo Enrico,
Fossati Maurizio,
Prada Alberto,
Tavani Enrico,
Minoli Giorgio
Publication year - 1998
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510270330
Subject(s) - medicine , alanine transaminase , gastroenterology , cirrhosis , interferon , hepatitis c virus , transaminase , hepatology , interferon alfa , hepatitis c , nested polymerase chain reaction , elevated transaminases , bdna test , alpha interferon , immunology , virus , polymerase chain reaction , biology , gene , enzyme , biochemistry
Most patients with serum hepatitis C virus (HCV) RNA and persistently normal alanine transaminase (ALT) levels show histological features of mild to moderately active chronic hepatitis. Some cirrhosis has also been reported. To assess whether interferon (IFN) treatment led to long‐term HCV suppression in these patients, 31 previously untreated patients (15 men, 16 women; mean age, 44 years) with serum HCV RNA, persistently normal ALT levels on at least four consecutive occasions 2 months apart, and histological features of chronic hepatitis (21 mild activity, 10 moderate activity) were randomized to receive IFN‐α‐2a, 3 MU three times a week for 6 months (n = 16), or no treatment (n = 15). All patients were followed up for at least 6 months after treatment ended. HCV RNA was tested by nested reverse‐transcription polymerase chain reaction (RT‐PCR) using 5′‐untranslated region complementary primers, quantified by branched‐DNA assay, and typed by nested RT‐PCR testing for the HCV core region. Treated and untreated patients had similar epidemiological, virological, and histological characteristics. At the end of treatment, serum HCV RNA was still detected in 15 patients (94%) and 14 controls (93%). ALT levels flared up in 10 patients receiving IFN (62%) and in 1 control (62% vs. 7%; P < .005, χ 2 test). In conclusion, 6 months' treatment with IFN‐α‐2a did not eradicate HCV RNA from serum in carriers with persistently normal ALT levels but caused ALT flare‐ups in two thirds of them. Until more is known about the natural history of HCV RNA carriers with normal ALT levels, these patients should not be treated with IFN.