Breakthrough during recombinant interferon alfa therapy in patients with chronic hepatitis C virus infection: prevalence, etiology, and management.
Recombinant interferon alfa (r-IFN alpha 2) has been shown to normalize the aminotransferase levels in approximately 50% of patients with chronic hepatitis C virus (HCV). Few patients experience a relapse during the treatment, in spite of a complete initial response (breakthrough). We studied 191 HCV Ab-positive patients with histologically proven chronic hepatitis. All of them were treated with r-IFN alpha 2 (3 MU three times a week). A complete response was seen in 54.4%. However, 12 of 104 responders experienced a breakthrough. At the time of breakthrough, neutralizing IFN antibodies were positive in 6 of 12 patients. Binding IFN antibodies were positive in all of these 12 patients. Continued treatment with r-IFN alpha 2, even at higher doses, did not restore the previous response in any patient. All of them were then switched to natural lymphoblastoid IFN, and this rapidly restored a complete response in all of the patients.
Roffi
L
L
First Department of Medicine, S. Gerardo Hospital, University of Milan, Monza, Italy.
Mels
G C
GC
Antonelli
G
G
Bellati
G
G
Panizzuti
F
F
Piperno
A
A
Pozzi
M
M
Ravizza
D
D
Angeli
G
G
Dianzani
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000906:Antibodies / Q000032:analysis; D002908:Chronic Disease; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000276:immunology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011994:Recombinant Proteins; D012008:Recurrence; D016896:Treatment Outcome
D000906:Antibodies; D016898:Interferon-alpha; D011994:Recombinant Proteins; D000410:Alanine Transaminase