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Can the response to interferon treatment be predicted in patients with chronic active hepatitis C?
Author(s) -
Lin R.,
Schoeman M. N.,
Craig P. I.,
Bilous M.,
Grierson J.,
McDonald J. A.,
Batey R. G.,
Farrell G. C.
Publication year - 1991
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1991.tb04715.x
Subject(s) - medicine , gastroenterology , cirrhosis , interferon , interferon alfa , liver disease , alpha interferon , surgery , immunology
Twenty‐one of 40 patients with chronic non‐A, non‐B hepatitis (37 anti‐HCV positive) were randomised to receive interferon α2b (3 million units subcutaneously thrice weekly for 24 weeks) and then to be observed for six months. Among the other 19 patients (controls) randomised to be observed without treatment for 12 months, eight have subsequently been treated with interferon for six months. One treated patient and three controls were lost to follow‐up. A return to normal serum alanine aminotransferase levels which lasted until the end of the treatment period occurred in 18 (64%) of the 28 patients given interferon (and in 13 of 21 (62%) randomised to treatment), but only in one of the 16 untreated controls ( p < 0.001). Multivariant analysis indicated that, compared with the ten nonresponders, the 18 patients who responded to interferon were more likely to have acquired infection by intravenous drug abuse than by blood transfusion ( p < 0.05), and were more likely to have histologically less severe chronic liver disease ( p < 0.01). Thus, all 13 patients with less severe liver disease histologically responded to interferon, but only five of 15 patients with cirrhosis or bridging fibrosis responded. Among 17 responders followed for more than four months, five (28%) are still in remission a median of 13 months (range four months to 24 months) after stopping interferon. The characteristics which favoured a response during treatment also appeared to distinguish those who experienced sustained post‐treatment remission. Thus, five of 12 patients with less severe chronic hepatitis C histologically appear to have a sustained remission of disease activity after treatment for six months with interferon, whereas none of five patients with cirrhosis or bridging fibrosis has had a sustained remission after interferon treatment. It is proposed that continued treatment with interferon may be required for long‐term suppression of chronic active hepatitis C among patients with bridging fibrosis or cirrhosis, but one course of interferon may provide a lasting response in 40% of patients with less severe disease.