Chronic hepatitis C: Clinical and immunological features and the effect of interferon treatment

Clinical and immunological findings on 74 patients with chronic hepatitis C are reported and experiences with interferon-alpha treatment of 31 patients are summarized. The transfusion history was noted in 69% of patients and the time elapsed from the transfusion to the diagnosis was a mean of 7.15 +/- 8.1 years. Concerning the severity of the liver disease, chronic persistent hepatitis was in 40%, active hepatitis in 45% and cirrhosis in 15% of the patients. Cholestasis was recorded in 32% of the cases. A significant elevation of serum immunoglobulin levels was noted in 83%, an antibody to liver-specific protein (anti-LSP) occurred in 80%, cryoglobulinaemia in 44% and circulating immune complexes in 33% of the patients. Natural killer cell activity of peripheral blood mononuclear cells significantly decreased. HLA B8 and DR3 antigens were found with increased frequency (36.6% and 42.1%). Recombinant interferon-alpha at a weekly dose of 3MU thrice, for six months, normalized serum alanine aminotransferase in 45% of patients and a sustained remission was found in 26%. The treatment resulted in the clearance of HCV-RNA from the serum in 40% of patients and that correlated well with the complete remission. In the good responders, a decrease in CD4+ cell count and a transient decrease in CD8+ cell count as well as a moderate rise in B cell count were seen during the treatment. Mitogen-induced lymphoproliferative response and natural killer cell activity increased. Predictors of response were as follows. female sex, shorter time elapsed from transfusion, absence of HLA A?, BE, DR3 and serum anti-HBc negativity.