Clinical

Peg-interferon treatment during acute HCV may prevent chronic infection

Last Updated: 2004-05-20 17:25:26 -0400 (Reuters Health)

NEW ORLEANS (Reuters Health) - Pegylated interferon alpha (peg-IFN) appears to be as effective in the treatment of acute hepatitis C (HCV) as it is in treating chronic infection, according to a new study. The medication may even prevent the disease from becoming chronic.

Dr. Sanaa M. Kamal, at Beth Israel Deaconess Medical Center in Boston, prospectively followed 40 patients with acute hepatitis that did not resolve on its after 12 weeks. She presented her findings at Digestive Disease Week.

"All subjects were enteric and symptomatic," she told conference attendees. Acute infection was determined by seronegative blood samples obtained during the 6 months prior to presentation.

Twenty patients were randomly assigned to treatment with peg-IFN alone for 24 weeks and 20 to peg-IFN plus ribavirin. At the end of treatment, HCV RNA levels were undetectable in 19 patients on dual therapy and in 18 on peg-IFN alone, she showed in her slide presentation.

At 48 weeks, treated patients' outcomes were compared with those of 14 untreated subjects with acute HCV. Sustained virological responses were observed in 85% of those in the peg-IFN/ribavirin group and in 80% in the peg-IFN group. In contrast, viremia cleared spontaneously in 37% of untreated patients.

In those with a sustained response to treatment, Dr. Kamal's group observed higher increases in HCV-specific CD4 T-helper 1 cells compared with those of spontaneous responders and those who developed chronic infection.

In those with durable treatment response and those with self-limited infection, CD4 T cell responses remained high, whereas levels were fluctuating and rapidly lost in those who developed chronic HCV infection.

"T cell responses may be crucial for development of more effective treatments for acute HCV," she concluded.

Digestive Disease Week is jointly sponsored by the American Association for the Study of Liver Diseases, the American Gastroenterological Association, the American Society for gastrointestinal Endoscopy, and the Society for Surgery of the Alimentary Tract.