Efficacy of a 24-week course of PEG-interferon alpha-2b monotherapy in patients with acute hepatitis C after failure of spontaneous clearance.
OBJECTIVE
Interferon (IFN) monotherapy significantly reduces the chronicity rate of acute hepatitis C (AHC) but optimal regimen and treatment timing remain undefined. The aim of this study was to assess the efficacy of a 6-month course of pegylated IFN (PEG-IFN) alpha-2b monotherapy in AHC patients and to investigate if IFN treatment initiated after 12 weeks from clinical presentation, still achieved a high response rate.


METHODS
Sixteen AHC patients still viremic after 12 weeks from the onset were treated with PEG-IFN alpha-2b (1.5 mcg/kg once weekly) for 6 months and followed for at least 12 months. Response to therapy was defined as normal ALT values and undetectable HCV RNA (<50 IU/ml) at the end of therapy, after 6 (sustained response) and 12 months follow-up (long-term response).


RESULTS
At the end of treatment, HCV RNA was undetectable in 15/16 patients while ALT normalized in 14/16 patients. After 6 and 12 months follow-up, 15/16 patients (94%) showed virological and biochemical response.


CONCLUSIONS
A 6-month course of PEG-IFN alpha-2b is effective in inducing resolution of AHC in 94% of patients. Our results provide a rationale for delaying treatment for 12 weeks, targeting only patients who fail to clear the virus spontaneously and truly requiring therapy without loss of efficacy.
Santantonio
Teresa
T
Clinic of Infectious Diseases, University of Bari, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy. t.santantonio@clininf.uniba.it
Fasano
Massimo
M
Sinisi
Emanuele
E
Guastadisegni
Angela
A
Casalino
Caterina
C
Mazzola
Michele
M
Francavilla
Ruggiero
R
Pastore
Giuseppe
G
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D011994:Recombinant Proteins; D015203:Reproducibility of Results; D017211:Treatment Failure; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b