A comparison of four types of interferon alpha in the treatment of chronic hepatitis C

Several clinical trials and mete-analyses have shown that the efficacy of interferon (IFN)-alpha in the treatment of chronic hepatitis C is variable, depending on the type of IFN-alpha used. We randomly assigned 220 patients with hepatitis C to receive a B-month treatment (3 megaunits three times per week) with lymphoblastoid IFN-alpha (group A), recombinant IFN alpha-2a (group B), leukocyte IFN-alpha (group C), or recombinant IFN alpha-ab (group D). The groups were homogeneous with reference to histologic severity of the disease (chronic persistent hepatitis, 21.4%; mild chronic active hepatitis, 28.2%; moderate chronic active hepatitis, 28.6%; and severe chronic active hepatitis, 21.8%). We used common laboratory techniques to detect and assess all serum variables. Liver biopsy was conducted according to Menghini's modified technique, and administration of IFN alpha was conducted according to a double-masked method. A total of 220 patients mere enrolled in the study. Ninety-two patients dropped out because of side effects, comorbidity unrelated to the baseline disease, or voluntary termination and 128 patients (32 patients in each group) completed the treatment course and the follow-up period. At the 6-month end point, 14 of 32 patients mere complete responders in group A, 13 of 32 in group B, 14 of 32 in group C, and 8 of 32 in group D. After completion of the follow-up period, 10 of 32 patients had a sustained response in group A, 9 of 32 in group B, 10 of 32 in group C, and 8 of 32 in group D. Treatment failure and relapse rates mere higher in the patients treated with recombinant alpha IFNs than in patients treated with leukocyte or lymphoblastoid IFN alpha. We observed no relation between the relapse rate and baseline severity of the disease. Among the recombinant IFNs, a major rate of clinical response was observed in patients treated with recombinant IFN alpha-as. Although leukocyte IFN-alpha and lymphoblastoid IFN-alpha treatments showed an overlapping efficacy in terms of complete or sustained response, the former achieved a lower rate of treatment failure or relapse.