Alpha-interferon treatment of HCV RNA positive patients with normal or near-normal alt levels

Should patients with chronic hepatitis c who have normal alt levels be treated?

“…In one study, 15 patients with HCV and normal or near normal ALT levels (<1.5 upper limit of normal) were treated with 3 million units (MU) of interferon three times a week for 6 months [11]. No patient developed a virologic sustained response, but none developed sustained elevations in ALT levels during or after therapy [11]. A study in which patients were randomized to receive either 3 MU three times a week or placebo reported no sustained responders in either group.…”

“…She Serfaty et al [14]. 10 3 MU three times/wk x 6 mo 20% Sangiovanni et al [12] 16 3 MU three times/wk x 6 mo 0 Rossini et al [8] 10 3 MU three times/wk x 12 mo 20% Silverman et al [11] 15 3 MU three times/wk x 6 mo 0 Tran et al [15] 11 3 MU three times/wk x 12 mo 18% end-of-treatment response Van Thiel et al [16] 37 5 MU daily x 6-12 mo 65% end-of-treatment response Orito et al [17] 16 10 MU three times/wk x 6 mo 37.5% ALT-alanine aminotransferase; mo-month; MU-million units; wk-week. now presents because she has learned that there are new therapies available, including interferon plus ribavirin and polyethylene-glyco-modified (PEGylated) interferon.…”

Patients with chronic hepatitis C who have normal ALT: A role for interferon-based therapy?

“…One study treated 15 patients with HCV and normal or near normal ALT levels (< 1.5 upper limit of normal) with 3 million units (MU) of interferon three times a week for 6 months [11]. No patient developed a virologic sustained response, and none developed sustained elevations of ALT levels during or after therapy [11]. A study that randomized patients to 3 MU three times a week or placebo reported no sustained responders in either group.…”

“…Women of child-bearing age with hepatitis C have presented with electing to undergo therapy prior to attempting pregnancy because they are concerned about transmitting hepatitis C to the fetus. They must practice [12] 16 3 MU TIW × 6 mo 0 Rossini et al [8] 10 3 MU TIW × 12 mo 20% Silverman et al [11] 15 3 MU TIW × 6 mo 0 Tran et al [14] 11 3 MU TIW × 12 mo 18% end-of-treatment response Van Thiel et al [15] 37 5 MU daily × 6-12 mo 65% end-of-treatment response Orito et al [16] 16 10 MU TIW × 6 mo 37.5% ALT-alanine aminotransferase; MU-million units; TIW-three times a week.…”

Patients with Chronic Hepatitis C - Who Should Not Be Treated?

“…Hepatitis C patients with persistently normal transaminase levels should not be treated with IFN because they seem to have a good long term prognosis in general, respond less well to IFN therapy and may exhibit transaminase flares during and after therapy (33)(34)(35)(36)(37)(38). Usually fibrosis is absent or minimal, and cirrhosis rarely develops.…”