Treatment of Chronic Hepatitis C with Recombinant Interferon Alfa

TLDR

Chronic hepatitis C is a common and often progressive viral liver disease. The study aimed to assess the efficacy of interferon alfa therapy in chronic hepatitis C patients. A randomized trial assigned 166 patients to receive 3 million or 1 million units of recombinant interferon alfa thrice weekly for 24 weeks, or no treatment. After 24 weeks, 46 % of patients receiving 3 million units and 28 % receiving 1 million units achieved near‑normal alanine aminotransferase levels, compared with 8 % in untreated patients; 85 % of responders to 3 million units had complete normalization, 56 % to 1 million units; histologic improvement was seen in the 3 million group; relapse occurred in 51 % (3 million) and 44 % (1 million) within six months post‑treatment. N Engl J Med 1989; 321:1501–6.

Abstract

Chronic hepatitis C (non-A, non-B hepatitis) is a common and often progressive viral liver disease. To assess the efficacy of therapy with the antiviral agent interferon alfa, we randomly assigned 166 patients with chronic hepatitis C to treatment with either 3 million or 1 million units of recombinant interferon alfa three times weekly for 24 weeks, or to no treatment. The probability of normalization or near normalization of the serum alanine aminotransferase levels after six months of interferon therapy was 46 percent in patients treated with 3 million units of interferon (P<0.001) and 28 percent in those treated with 1 million units (P<0.02), but only 8 percent in untreated patients. The serum alanine aminotransferase level became completely normal in 22 of the 26 patients (85 percent) who responded to treatment with 3 million units of interferon and 9 of the 16 patients (56 percent) who responded to treatment with 1 million units. The patients who received 3 million units of interferon had histologic improvement because of the regression of lobular and periportal inflammation. Relapse within six months after the completion of treatment occurred in 51 percent of the patients treated with 3 million units of interferon and 44 percent of those treated with 1 million units. We conclude that a 24-week course of interferon therapy is effective in controlling disease activity in many patients with hepatitis C, although relapse after the cessation of treatment is common. (N Engl J Med 1989; 321: 1501–6.)