High-Dose Interferon Alpha-2b Prevents Chronic Hepatitis C
WESTPORT, CT (Reuters Health) Nov 14 - Early treatment of
acute hepatitis C
with a relatively short, high-dose regimen of interferon
the development of chronic infection in most patients, German
report in the New England Journal of Medicine for November 15.
Forty-four patients with acute hepatitis C were treated with 5
million U of
interferon alpha-2b SC daily for 4 weeks, followed by 5
million U three
times a week for an additional 20 weeks. Time from infection
to the first
signs or symptoms of illness ranged from 15 to 105 days (mean
while the time from infection until start of therapy was 30 to
(mean 89 days).
Dr. Michael P. Manns, of the Medizinische Hochschule Hannover,
of the German Acute Hepatitis C Therapy Group documented that
time required for Hepatitis C Virus RNA to become undetectable after
was 3.2 weeks. All patients reached this goal during therapy.
All but nine patients had normal alanine aminotransferase
levels by the end
of therapy. Those nine exhibited a mild elevation of not more
than twice the
upper limit of the normal range. Although thrombocytopenia and
developed in all patients, these abnormalities resolved after
Dr. Jay H. Hoofnagle, of the National Institute of Diabetes
and Kidney Diseases in Bethesda, Maryland, notes in an
editorial that the
recovery rate observed by Dr. Manns' team well exceeds the
spontaneous recovery rate of 15% to 30%. The rate is also
higher than the
best rate observed for patients with chronic hepatitis C.
Still, Dr. Hoofnagle questions the value of initiating therapy
in patients with acute infection, given the low rate of
mortality during the first 2 decades of chronic liver disease.
that another strategy, delaying therapy to see if the
spontaneously, may be feasible.
N Engl J Med 2001;345:1452-1457,1495-1497.