Efficacy of a 24-week course of PEG-interferon alpha-2b monotherapyin patients with acute hepatitis c after failure of spontaneous clearance

ABSTRACT

Interferon [IFN] monotherapy significantly reduces the chronicity rate of acute hepatitis C [AHC] but optimal regimen and treatment timing remain undefined. The aim of this study was to assess the efficacy of a 6-month course of pegylated IFN [PEG-IFN] alpha-2b monotherapy in AHC patients and to investigate if IFN treatment initiated after 12 weeks from clinical presentation, still achieved a high response rate. Sixteen AHC patients still viremic after 12 weeks from the onset were treated with PEG-IFN a-2h [1.5 mcg/kg once weekly] for 6 months and followed for at least 12 months. Response to therapy was defined as normal ALT values and undetectable HCV RNA [<50 IU/ml] at the end of therapy, after 6 [sustained response] and 12 months follow-up [long-term response]. At the end of treatment, HCV RNA was undetectable in 15/16 patients while ALT normalized in 14/16 patients. After 6 and 12 months follow-up, 15/16 patients [94%] showed virological and biochemical response. A 6-month course of PEG-IFN alpha-2b is effective in inducing resolution of AHC in 94% of patients. Our results provide a rationale for delaying treatment for 12 weeks, targeting only patients who fail to clear the virus spontaneously and truly requiring therapy without loss of efficacy