Non responders to interferon therapy among chronic hepatitis patients infected with hepatitis C virus
We studied a series of 268 chronic hepatitis C patients (31 chronic persistent hepatitis CPH, 69 mild chronic active hepatitis CAH, 125 severe CAH, and 43 active cirrhosis) enrolled from 1988 to 1991 in different therapeutic protocols using lymphoblastoid or recombinant interferon (IFN) at a dosage of 3 mega units (M.U.), three times a week for 12 months. Of these patients 54.8% showed a complete response (normalization of aminotransferases), 14.2% a partial response (decrease in aminotransferases of over 50%), 27.6% no response, and 3.4% a substantial progressive increase in the liver enzymes during IFN (becoming worse). The prevalence of non responders was lower in CPH (9.7%) than in CAH patients (31.9% in the mild form and 20.8% in the severe), and significantly higher in patients with cirrhosis (53.5%). No correlation was observed between non response and the baseline aminotransferase level or the patient’s sex. Patients under 35 had a better response to IFN when compared with patients 36–50 years. This is probably due to the higher prevalence of CPH patients with a good response to IFN in the youngest group. No effect was gained in non responders by increasing the dose or shifting from recombinant to lymphoblastoid IFN; three patients were then treated with steroids, but only one benefitted. For 5 of the 9 patients who became worse, steroids were started after discontinuation of IFN therapy, and they induced a favorable response only for the 3 who had developed autoantibodies during IFN treatment.
KeywordsChronic Hepatitis Chronic Hepatitis Patient Active Cirrhosis Recombinant Human Alpha Interferon Response Response Response
Unable to display preview. Download preview PDF.
- 1.Alberti A, Chemello G, Diodati G (1992) Treatment of chronic hepatitis C with different regimens of interferon alpha-2a (IFN-2a). Hepatology 16: 75AGoogle Scholar
- 2.Cammà C, Craxi A, Tinè F (1992) Predictors of response to alpha-interferon (IFN) in chronic hepatitis C: a multivariate analysis on 361 treated patients. Hepatology 16: 131AGoogle Scholar
- 3.Davis GL, Baiart LA, Schiff ER, Lindsay KL, Bodenheimer HC, Perrillo RP, Carey W, Jacobson IM, Payne J, Dienstag JL, Van Thiel DH, Tamburro C, Lefkowitch J, Albrecht J, Meschievitz C, Ortego TJ, Gibas A, The Hepatitis Interventional Therapy (HIT) Group (1989) Treatment of chronic hepatitis C with recombinant alpha interferon. A multicenter randomized, controlled trial. N Engl J Med 321: 1501–1506Google Scholar