מתוך medicontext.co.il
By Anthony J. Brown, MD
WESTPORT, CT (Reuters Health) – Interferon alfa-2b is often used to treat chronic hepatitis C, but a report released Monday indicates that it can also prevent chronic infection in patients with acute disease.
The report, which will be published in the November 15th issue of The New England Journal of Medicine, was released early due to its potential clinical importance.
Dr. Michael P. Manns, from the Medizinische Hochschule Hannover in Germany, and colleagues assessed the virologic outcomes of 44 patients with acute hepatitis C who received interferon alfa-2b.
In a previous study, Dr. Mann's group compared interferon with peginterferon as a treatment for chronic hepatitis C and found that the viral response rate was greater with peginterferon. (See Reuters Health story, September 20.)
In the current study, patients received 4 weeks of 5 million U interferon daily therapy followed by 20 weeks of thrice-weekly therapy. Serum hepatitis C viral RNA levels were measured before, during, and 24 weeks after therapy was given.
Altogether, 42 of the 43 patients who completed followup had normal serum alanine aminotransferase levels and undetectable HCV RNA levels, the authors note. On average, it only took 3.2 weeks of treatment for HCV RNA levels to become undetectable. In general, interferon therapy was well tolerated, with only one patient stopping therapy due to side effects.
"These findings show that nearly 100% of patients with acute hepatitis C can be cured with interferon monotherapy," Dr. Manns told Reuters Health. "Some studies have shown that treatment of acute hepatitis C is beneficial, but this is the first nationwide prospective study to demonstrate the effectiveness of a particular therapy," he noted.
"Up to 80% of patients with acute hepatitis C become chronic carriers," Dr. Manns pointed out. "Treatment in the acute stage can prevent patients from become chronic carriers and thus reduce the transmission risk."
"The one patient who experienced a relapse had multiple sclerosis and was receiving steroids," said Dr. Manns. "Therefore, we have an idea why this patient failed therapy."
"It is really hard to beat the 97% success rate we had with interferon," he concluded, "but we are investigating the use of pegylated interferon mostly because the treatment schedule is more convenient for patients."
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