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Interferon treatment for chronic hepatitis C infection in hemophiliacs--
influence of virus load, genotype, and liver pathology on response
JP Hanley, LM Jarvis, J Andrew, R Dennis, PC Hayes, J Piris, R Lee, P Simmonds and CA Ludlam
Department of Haematology, Royal Infirmary of Edinburgh, Scotland.
In this study, we assessed the effectiveness of interferon treatment in 31
hemophiliacs with chronic hepatitis C virus (HCV) infection. Interferon
alfa-2a (3 MU three times weekly) was administered for 6 months. Response
was assessed by both serial alanine transaminase (ALT) and HCV RNA levels
measured by a sensitive semiquantitative polymerase chain reaction (PCR)
method. HCV genotype was determined by restriction fragment length
polymorphism (RFLP), and evidence of changing genotypes during interferon
therapy was sought. Severity of liver disease was assessed by both
noninvasive and invasive methods, including laparoscopic liver inspection
and biopsy. Sustained normalization of ALT levels occurred in eight
patients (28%), and seven (24%) became nonviremic as assessed by PCR
(<80 HCV/mL). Responders universally cleared HCV RNA within 2 months of
starting interferon. Genotype 3a was associated with a favorable response
to interferon. No evidence was found for a change in circulating genotype
in patients who failed to respond to interferon or who relapsed. This study
confirms that response rates to interferon are low in hemophiliacs as
compared with other groups with chronic HCV infection. We have also
demonstrated that virus load measurement over the first 8 to 12 weeks of
treatment is an extremely useful method to identify responders at an early
stage.
Volume 87,
Issue 5,
pp. 1704-1709,
03/01/1996
Copyright © 1996 by The American Society of Hematology
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