Several studies have reported the spontaneous loss of hepatitis C virus (HCV) antibodies in HCVexposed persons. However, the relationship between seroreversion and spontaneous virus clearance has yet to be precisely determined in a single homogeneous population of untreated immunocompetent patients. In this study, 32 human immunodeficiency virus -seronegative hemophiliacs who had been exposed to HCV were followed for a mean duration of 141 months; 22 remained chronic carriers (68.8%). All but 1 of the nonviremic patients (90.0%) showed partial (8 cases) or complete (2 cases) seroreversion. In contrast, all but 1 of the viremic patients (95.1%) had a stable serologic profile when analyzed by a recombinant immunoblot assay. The results indicate that any HCV antibody -positive immunocompetent patient with no detectable serum HCV RNA and normal alanine aminotransferase values and whose serial samples show a progressive decrease in the level of HCV antibodies present may be considered as having a resolved infection. Hepatitis C virus (HCV) infection is often characterized byPatients and Methods a chronic carriage of the virus, leading to chronic hepatitis, cirrhosis, and liver cell carcinoma [1,2]. It is frequently asPatients. One hundred seven hemophiliacs were followed as sumed that at least 50% of exposed persons remain chronically outpatients between July 1995 and December 1996 in our hemophilia treatment center. As the aim of this study was to analyze infected after primary infection [1]. Initial diagnosis of HCV serologic changes in HCV antibody levels with disease progresinfection is by detection of HCV antibody by EIA. This techsion, we retained only patients who had been followed for at least nique has been greatly improved over the last few years [3,4]. pearance of HCV antibodies may be predictive of self-limited For every patient, whether positive or negative for HCV antiinfection [6 -9]. We undertook a retrospective longitudinal body in 1995-1996, the oldest available serum sample was also study in a cohort of immunocompetent hemophiliacs with longtested to make it possible to date the seroconversion period for term follow-up to investigate this hypothesis.those who tested positive and to detect possible serologic proof of previous infection for those who tested negative. The oldest serum sample that we tested was collected in April 1981. Changes in the serologic profile were analyzed by RIBA using at least 3 serum

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A 57-year-old man with chronic inflammatory demyelinating polyneuropathy associated with hepatitis C virus infection was treated successfully with the combination of peginterferon-alpha-2b and ribavirin. Viral eradication was confirmed during the 4th week of treatment and was followed 3 weeks later by neurologic improvement. The patient resumed normal activity 1 year after the therapy was completed.

Differences in the populations studied could account for these discrepancies. In a previous study, we found that anti-HIV negative homosexuals with chronic hepatitis B seemed to respond as frequently as heterosexuals to ARA AMP treatment.3 In the same study, we found retrospectively that a low level of hepatitis B virus replication, as reflected by low serum hepatitis B virus DNA concentrations, was a factor for predicting response to ARA AMP.The aims of this study were to assess, in patients with chronic hepatitis B: (a) the response to ARA AMP according to the pretreatment concentration of serum hepatitis B virus DNA, (b) the kinetics of the antiviral effect of ARA AMP as assessed by a quantitative method, and (c) the efficacy of a second course of ARA AMP given six months after a first ineffective course. Methods PATIENTSSixty patients (aged 18-75) with chronic hepatitis B were enrolled in this multicentre trial. Entry criteria were (a) presence of HBsAg in serum for more than one year; (b) presence of HBeAg and absence of antiHBe antibodies; (c) increased activities of serum alanine aminotransferase (ALT) with stable values assessed three times within the six months before inclusion (less than 50% change); (d)

These results highlight an improvement in both physical and mental HRQL during HCV treatment, but no major improvement in physical HRQL after treatment end, when comparing PEG-IFN-free regimens with PEG-IFN-containing regimens. This suggests that in the PEG-IFN-free regimens era, screening and comprehensive care of comorbidities and residual somatic symptoms during treatment, and especially after HCV clearance, are still needed to improve patient outcomes.