Treatment of acute hepatitis C with interferon alpha-2b: early initiation of treatment is the most effective predictive factor of sustained viral response
[en] AIM: To evaluate the efficacy of early interferon alpha-2b in non-post-transfusion acute hepatitis C virus: a prospective study with historical comparison. PATIENTS: Group A: 28 patients prospectively treated for acute hepatitis C virus with daily regimen of interferon 5 million units for 2 months. Group B: historical series of 16 patients with untreated acute hepatitis C virus. RESULTS: There was no significant difference between the two groups with regard to gender, age, icterus, alanine aminotransferase, or genotypes. In group B, hepatitis spontaneously resolved in three of 16 (19%) patients (follow-up 1-7 years). In group A, 21 of 25 patients became sustained viral responders (75%; P = 0.0003 vs. group B). Factors include not predictive of sustained viral response: age, gender, sources of infection, presence of icterus, alanine aminotransferase peak, bilirubin peak, incubation period, presence of hepatitis C virus antibodies at presentation, or genotypes. The time from presentation to the start of therapy was, however, significantly shorter in sustained viral responders (43 +/- 31 days) than in relapsers or non-responders (88 +/- 52 days) (P = 0.016). CONCLUSIONS: Early treatment of acute hepatitis C virus with interferon prevents chronicity. A short waiting time from presentation to treatment appears as the most relevant predictive factor for sustained response.
Treatment of acute hepatitis C with interferon alpha-2b: early initiation of treatment is the most effective predictive factor of sustained viral response
Barrera JM, Bruguera M, Ercilla MG, et al. Persistent hepatitis C viremia after acute self-limiting post-transfusion hepatitis C. Hepatology 1995; 21: 639-44.
Seef LB, Hollinger FB, Alter HJ, et al. Long-term mortality and morbidity of transfusion-associated non-A, non-B, and type C hepatitis: a National Heart, Lung, and Blood Institute collaborative study. Hepatology 2001; 33: 455-63.
Thomas D, Astemborski J, Rai R, et al. The naturalhistory of hepatitis C virus infection. Host, viral, and environmental factors. JAMA 2000; 284: 450-456.
Villano SA, Vlahov D, Nelson KE, Cohn S, Thomas DL. Persistence of viremia and the importance of long-term follow-up after acute hepatitis C infection. Hepatology 1999; 29: 908-14.
Santantonio T, Sinisi E, Guastadisegni A, et al. Natural history of acute hepatitis C: a long-term prospective study. Dig Liver Dis 2003; 35: 104-13.
Rodgers AJ, Roberts S, Laginan A, Bowden T, Croft N. Assessment of long term outcomes of community-acquired hepatitis C infection in a cohort with sera stored from 1971 to 1975. Hepatology 2000; 32: 582-7.
Gerlach JT, Diepolder HM, Zachoval R, et al. Acute hepatitis C: high rate of both spontaneous and treatment-induced viral clearance. Gastroenterology 2003; 125: 80-8.
Kenny-Walsh E. for the Irish Hepatology Research Group. Clinical outcomes after hepatitis C infection from contaminated anti-immune globulins. N Engl J Med 1999; 340: 1228-33.
Gerlach TJ, Zachoval R, Gruener N, et al. Acute hepatitis C: natural course and response to antiviral treatment. Hepatology 2001; 34: 341A.
Alric L, Fort M, Izopet J, et al. Study of host- and virus-related factors associated with spontaneous hepatitis C virus clearance. Tissue Antigens 2000; 56: 154-8.
Vogt M, Lang T, Frosner G, et al. Prevalence and clinical outcome of hepatitis C infection in children who underwent cardiac surgery before implementation of blood donors screening. N Engl J Med 1999; 341: 866-70.
Alberti A, Boccato S, Vario A, Benvegnù L. Therapy of acute hepatitis C. Hepatology 2002; 36: S195-S200.
Hoofnagle JH. Therapy for acute hepatitis C. N Engl J Med 2001; 345: 1495-7.
Takano S, Satomura Y, Omata M. Japan Acute Hepatitis Cooperative Study Group. Effects of Interferon beta on non-A. non-B acute hepatitis: a prospective, randomized, controlled-dose study. Gastroenterology 1994; 107: 805-11.
Licata A, Di Bona D, Schepis F, Shahied L, Craxi A, Camma C. When and how to treat acute hepatitis C? J Hepatol 2003; 39: 1056-62.
Delwaide J, Bourgeois N, Gerard C, Wain E, Vaira D, Belaiche J. Treatment of acute hepatitis C with interferon alfa-2b prevents chronicity (abstract). Hepatology 1999; 30: 264.
Jaeckel E, Cornberg M, Wedemeyer H, et al. for the German Acute Hepatitis C Therapy Group. Treatment of acute hepatitis C with interferon alfa-2b. N Engl J Med 2001; 345: 1452-7.
Vogel W, Graziadei I, Umlauft F, et al. High-dose interferon-a2b treatment prevents chronicity in acute hepatitis C. A pilot study. Dig Dis Sci 1996; 41: 81S-5S.
Wiegand J, Boecher W, Buggish P, et al. 24 weeks of monotherapy with pegylated interferon alfa-2b in patients with acute hepatitis C (abstract). Hepatology 2003; 38: 250
Hofer H, Watkins-Riedel T, Janata O, et al. Spontaneous viral clearance in patients with acute hepatitis C can be predicted by repeated measurements of serum viral load. Hepatology 2003; 37: 60-4.
