A long-term follow-up study of interferon treatment for chronic hepatitis C in Japanese patients with congenital bleeding disorders.
Twenty-one HIV negative Japanese patients with chronic hepatitis C who had congenital bleeding disorders, 15 hemophilia A, 3 hemophilia B, 1 von Willebrand's disease, 1 afibrinogenemia and 1 thrombasthenia, were treated with 9 million units 3 times a week of natural interferon (IFN)-alpha for 6 months. They were followed, biochemically and virologically, for at least 18 months after therapy discontinuation to evaluate the long-term results. Liver biopsy, hepatitis C virus (HCV) genotyping and quantification of viral load by polymerase chain reaction (PCR) were performed to identify the predictors of a favorable response to IFN treatment. One male patient with hemophilia A dropped out because of general fatigue and was excluded from evaluation. Ten (50.0%) patients continued to be HCV RNA negative in serum together with normal ALT levels throughout the study. Subtype 1b and a high level of viremia significantly associated with an unfavorable outcome on the response to IFN although liver histology was not definitive for predicting the response. We concluded that a 6-month treatment with high doses of natural IFN-alpha was effective in inducing a long-term response without relapse of viremia in 50% of chronic hepatitis C patients with congenital bleeding disorders and that HCV subtype and pretreatment level of viremia were useful predictors of the response to IFN in treating such patients.
Yamada
M
M
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Fukuda
Y
Y
Koyama
Y
Y
Nakano
I
I
Urano
F
F
Isobe
K
K
Takamatsu
J
J
Imoto
M
M
Hayakawa
T
T
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers; D001707:Biopsy, Needle; D005260:Female; D005500:Follow-Up Studies; D006474:Hemorrhagic Disorders / Q000150:complications* / Q000235:genetics; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000201:enzymology / Q000628:therapy* / Q000821:virology; D006521:Hepatitis, Chronic / Q000150:complications / Q000201:enzymology / Q000628:therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D007564:Japan; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D016896:Treatment Outcome; D014766:Viremia / Q000150:complications / Q000517:prevention & control / Q000628:therapy / Q000821:virology
D000998:Antiviral Agents; D015415:Biomarkers; D016898:Interferon-alpha; D000410:Alanine Transaminase