Serum HCV RNA Levels in Patients with Chronic Hepatitis C Given a Second Course of Interferon alpha-2b Treatment after Relapse following Initial Treatment

Abstract

10 patients with chronic hepatitis C virus (HCV) infection who previously had responded temporarily to 9 months interferon alpha-2b treatment with normalization of ALT levels during treatment but later relapse were given a second 6-month treatment course. All patients were positive for anti-HCV by a second generation ELISA confirmed by second generation RIBA and positive for HCV RNA in serum before retreatment with interferon. Serum HCV RNA titers and ALT levels were monitored before, during and after treatment. ALT levels fell significantly from mean 1.95 μkat/l before treatment to mean 0.% and 0.85 μkat/l after 4 and 24 weeks treatment, respectively (p < 0.005 – p < 0.009). Six patients had normal ALT levels (< 0.7 μkat/l) at treatment stop. 12 weeks post treatment cessation, however, the mean ALT level, 2.29 μkat/l, was not significantly changed from the pretreatment level and all patients had raised ALT levels. The mean pretreatment HCV RNA titer in serum 10^s (range 10⁷–10^3,5) fell in all patients to mean 10^1.3 (range 10³–10⁰) already after 4 weeks treatment and became undetectable at treatment cessation in 5 patients, of whom 4 had normal ALT levels. ALT levels, however, were also normal in 2/5 patients who continued to have detectable HCV RNA titers at treatment cessation. After treatment was stopped HCV RNA titers rose again and 12 weeks post treatment the mean titer was 10^4.7 (range 10^3.5–10^5.5).

It was concluded that a second 6-month course of interferon alpha-2b treatment induced a response once again in most patients with chronic HCV infection who had relapsed after earlier temporarily successful treatment, and that HCV RNA titers in serum fell to undetectable levels during treatment in 50% of the patients, but that all relapsed again soon after treatment cessation.