Treatment of chronic hepatitis C infection with IFN-alpha: Long term results and predictive factors

Chronic hepatitis C virus(HCV) infection carries a 30% risk of cirrhosis which mandates an effective treatment. Currently, Interferon-alpha(Ifn-alpha) is the only established treatment method. Over four year period we treated and followed 40 patients with recombinant Ifn-alpha 2b, 3 MU tiw. Response was defined as complete normalization of ALT. Sustained meant no flare in the 18 months period following treatment. The treatment was stopped in the patients who did not respond at tile end of three months. Responders completed a 12 month-course of treatment. All the responders were followed-up 18 months untreated. 23/40(58%) responded, but 15/23(65%) relapsed. The sustained remission rate was 8/40(20%). However 2/8(20%) were HCV-RNA +ve despite sustained normalization of ALT. Overall, virologic sustained remission was achieved in 6/40(15%.) Pre-treatment fibrosis score significantly(p<0.05) correlated(inversely) with sustained remission rate. Iii conclusion: The overall sustained biochemical, and biochemical/virologic response rates, running at 20%, and %15, respectively, with IFN, raises tile necessity for more powerful adjuncts, such as ribavirin.