Virological and biochemical long-term follow-up of patients with chronic hepatitis C treated with interferon.
We studied the long-term outcomes of 43 patients with chronic hepatitis C treated with one or two interferon cycles, in relation to hepatitis C virus RNA in serum and peripheral-blood mononuclear cells. After the first interferon cycle, 15 (35%) patients had normal transaminase levels, although only five of them had normal levels throughout follow-up (complete responders). After treatment, hepatitis C virus RNA was detected in serum and peripheral-blood mononuclear cells with a similar frequency among the five complete responders (60% and 40%, respectively) and the 10 responders with relapse (50% and 20%, respectively). During the follow-up of the complete responders (up to 27 mo), fluctuating viremia levels were found, as demonstrated by the intermittent serum hepatitis C virus RNA positivity. In responders with relapse serum hepatitis C virus RNA reappeared concurrent with the relapse, without changes in peripheral-blood mononuclear cells. A second interferon cycle was performed in 23 nonresponders. Six of them had normalized transaminase levels but four had relapses. After retreatment, hepatitis C virus RNA was detected in peripheral-blood mononuclear cells with the same frequency (50%) in complete responders and in responders with relapse. Loss of serum hepatitis C virus RNA was only achieved in responders with relapse. During the follow-up, half of the complete responders lost serum hepatitis C virus RNA. This marker reappeared in responders with relapse, and hepatitis C virus RNA was found de novo in PBMCs of one responder with relapse. None of the 17 nonresponders to retreatment lost hepatitis C virus RNA in serum or PBMCs during therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Castillo
I
I
Hepatology Unit, Fundación Jiménez Díaz, Madrid, Spain.
Bartolomé
J
J
Navas
S
S
Gonzalez
S
S
Herrero
M
M
Carreño
V
V
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001483:Base Sequence; D002908:Chronic Disease; D017931:DNA Primers / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D016896:Treatment Outcome
D017931:DNA Primers; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D000410:Alanine Transaminase