FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Published at www.nejm.org October 1, 2001 (10.1056/NEJMoa011232)

	PDF Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited

ABSTRACT

(Notice: Because of its potential clinical implications, this article is being published early [on October 1, 2001]. It will appear in the November 15 issue of the Journal. Click on "PDF of this article" for the full text.)

Background In people who are infected with the hepatitis C virus (HCV) chronic infection often develops and is difficult to eradicate. We sought to determine whether treatment during the acute phase could prevent the development of chronic infection.

Methods Between 1998 and 2001, we identified 44 patients throughout Germany who had acute hepatitis C. Patients received 5 million U of interferon alfa-2b subcutaneously daily for 4 weeks and then three times per week for another 20 weeks. Serum HCV RNA levels were measured before and during therapy and 24 weeks after the end of therapy.

Results The mean age of the 44 patients was 36 years; 25 were women. Nine became infected with HCV through intravenous drug use, 14 through a needle-stick injury, 7 through medical procedures, and 10 through sexual contact; the mode of infection could not be determined in 4. The average time from infection to the first signs or symptoms of hepatitis was 54 days, and the average time from infection until the start of therapy was 89 days. At the end of both therapy and follow-up, 42 of the 43 patients who have completed follow-up (98 percent) had undetectable levels of HCV RNA in serum and normal serum alanine aminotransferase levels. Levels of HCV RNA became undetectable after an average of 3.2 weeks of treatment. Therapy was well tolerated in all but one patient, who stopped therapy after 12 weeks because of side effects.

Conclusions Treatment of acute hepatitis C with interferon alfa-2b prevents chronic infection.

This article has been cited by other articles:

• Page-Shafer, K., Pappalardo, B. L., Tobler, L. H., Phelps, B. H., Edlin, B. R., Moss, A. R., Wright, T. L., Wright, D. J., O'Brien, T. R., Caglioti, S., Busch, M. P. (2008). Testing Strategy To Identify Cases of Acute Hepatitis C Virus (HCV) Infection and To Project HCV Incidence Rates. J. Clin. Microbiol. 46: 499-506 [Abstract] [Full Text]  
• Irving, W. L. (2007). Guidelines on prevention of transmission of hepatitis C virus infection in the workplace: do they work in practice?. Occup Med (Lond) 57: 542-544 [Full Text]  
• Gibson, K., Kennedy, I. (2007). Implementation of the hepatitis C guidelines in UK health care workers. Occup Med (Lond) 57: 599-601 [Abstract] [Full Text]  
• Kim, C. S., Jung, J. H., Wakita, T., Yoon, S. K., Jang, S. K. (2007). Monitoring the Antiviral Effect of Alpha Interferon on Individual Cells. J. Virol. 81: 8814-8820 [Abstract] [Full Text]  
• Hamlyn, E., Easterbrook, P. (2007). Occupational exposure to HIV and the use of post-exposure prophylaxis. Occup Med (Lond) 57: 329-336 [Abstract] [Full Text]  
• Makary, M. A., Al-Attar, A., Holzmueller, C. G., Sexton, J. B., Syin, D., Gilson, M. M., Sulkowski, M. S., Pronovost, P. J. (2007). Needlestick Injuries among Surgeons in Training. NEJM 356: 2693-2699 [Abstract] [Full Text]  
• Byrnes, A. A., Li, D.-Y., Park, K., Thompson, D., Mocilnikar, C., Mohan, P., Molleston, J. P., Narkewicz, M., Zhou, H., Wolf, S. F., Schwarz, K. B., Karp, C. L. (2007). Modulation of the IL-12/IFN-{gamma} axis by IFN-{alpha} therapy for hepatitis C. J. Leukoc. Biol. 81: 825-834 [Abstract] [Full Text]  
• Lynch, R. A., Etchin, J., Battle, T. E., Frank, D. A. (2007). A Small-Molecule Enhancer of Signal Transducer and Activator of Transcription 1 Transcriptional Activity Accentuates the Antiproliferative Effects of IFN-{gamma} in Human Cancer Cells. Cancer Res. 67: 1254-1261 [Abstract] [Full Text]  
• Hoofnagle, J. H., Seeff, L. B. (2006). Peginterferon and Ribavirin for Chronic Hepatitis C. NEJM 355: 2444-2451 [Full Text]  
• Manns, M P, Wedemeyer, H, Cornberg, M (2006). Treating viral hepatitis C: efficacy, side effects, and complications.. Gut 55: 1350-1359 [Full Text]  
• Irving, W L (2006). Acute hepatitis C virus infection: a neglected disease?. Gut 55: 1075-1077 [Full Text]  
• Turner, J M, Rider, A T, Imrie, J, Copas, A J, Edwards, S G, Dodds, J P, Stephenson, J M, on behalf of the SHARP Study Group, (2006). Behavioural predictors of subsequent hepatitis C diagnosis in a UK clinic sample of HIV positive men who have sex with men.. Sex. Transm. Infect. 82: 298-300 [Abstract] [Full Text]  
• Kelloff, G. J., Lippman, S. M., Dannenberg, A. J., Sigman, C. C., Pearce, H. L., Reid, B. J., Szabo, E., Jordan, V. C., Spitz, M. R., Mills, G. B., Papadimitrakopoulou, V. A., Lotan, R., Aggarwal, B. B., Bresalier, R. S., Kim, J., Arun, B., Lu, K. H., Thomas, M. E., Rhodes, H. E., Brewer, M. A., Follen, M., Shin, D. M., Parnes, H. L., Siegfried, J. M., Evans, A. A., Blot, W. J., Chow, W.-H., Blount, P. L., Maley, C. C., Wang, K. K., Lam, S., Lee, J. J., Dubinett, S. M., Engstrom, P. F., Meyskens, F. L. Jr., O'Shaughnessy, J., Hawk, E. T., Levin, B., Nelson, W. G., Hong, W. K., for the AACR Task Force on Cancer Prevention, (2006). Progress in Chemoprevention Drug Development: The Promise of Molecular Biomarkers for Prevention of Intraepithelial Neoplasia and Cancer--A Plan to Move Forward. Clin. Cancer Res. 12: 3661-3697 [Abstract] [Full Text]  
• De Rosa, F. G., Bargiacchi, O., Audagnotto, S., Garazzino, S., Cariti, G., Raiteri, R., Di Perri, G. (2006). Dose-dependent and genotype-independent sustained virological response of a 12 week pegylated interferon alpha-2b treatment for acute hepatitis C. J Antimicrob Chemother 57: 360-363 [Abstract] [Full Text]  
• Lauer, G. M., Lucas, M., Timm, J., Ouchi, K., Kim, A. Y., Day, C. L., zur Wiesch, J. S., Paranhos-Baccala, G., Sheridan, I., Casson, D. R., Reiser, M., Gandhi, R. T., Li, B., Allen, T. M., Chung, R. T., Klenerman, P., Walker, B. D. (2005). Full-Breadth Analysis of CD8+ T-Cell Responses in Acute Hepatitis C Virus Infection and Early Therapy. J. Virol. 79: 12979-12988 [Abstract] [Full Text]  
• Yu, M.-L., Hou, N.-J., Dai, C.-Y., Chang, W.-Y., Chuang, W.-L. (2005). Successful Treatment of Fulminant Hepatitis C by Therapy with Alpha Interferon and Ribavirin. Antimicrob. Agents Chemother. 49: 3986-3987 [Full Text]  
• Cox, A. L., Mosbruger, T., Mao, Q., Liu, Z., Wang, X.-H., Yang, H.-C., Sidney, J., Sette, A., Pardoll, D., Thomas, D. L., Ray, S. C. (2005). Cellular immune selection with hepatitis C virus persistence in humans. J. Exp. Med. 201: 1741-1752 [Abstract] [Full Text]  
• Teta, D., Luscher, B. L., Gonvers, J.-J., Francioli, P., Phan, O., Burnier, M. (2005). Pegylated interferon for the treatment of hepatitis C virus in haemodialysis patients. Nephrol Dial Transplant 20: 991-993 [Full Text]  
• Herring, B. L., Tsui, R., Peddada, L., Busch, M., Delwart, E. L. (2005). Wide Range of Quasispecies Diversity during Primary Hepatitis C Virus Infection. J. Virol. 79: 4340-4346 [Abstract] [Full Text]  
• Menkes, D. L. (2005). Pegylated Interferon vs Standard Interferon for Chronic Hepatitis C. JAMA 293: 1323-1323 [Full Text]  
• Manns, M. P., Wedemeyer, H. (2004). Treatment of Hepatitis C in HIV-Infected Patients: Significant Progress But Not the Final Step. JAMA 292: 2909-2913 [Full Text]  
• Spada, E, Mele, A, Berton, A, Ruggeri, L, Ferrigno, L, Garbuglia, A R, Perrone, M P, Girelli, G, Del Porto, P, Piccolella, E, Mondelli, M U, Amoroso, P, Cortese, R, Nicosia, A, Vitelli, A, Folgori, A, on behalf of the Acute Hepatitis C Italian Study G, (2004). Multispecific T cell response and negative HCV RNA tests during acute HCV infection are early prognostic factors of spontaneous clearance. Gut 53: 1673-1681 [Abstract] [Full Text]  
• Teo, M., Hayes, P. (2004). Management of hepatitis C. Br Med Bull 70: 51-69 [Abstract] [Full Text]  
• Pimstone, N. R., Pimstone, D., Saicheur, T., Powell, J., Yu, A. S. (2004). "Wait-and-See": An Alternative Approach to Managing Acute Hepatitis C with High-Dose Interferon-{alpha} Monotherapy. ANN INTERN MED 141: W-91-W-92 [Full Text]  
• Dhumeaux, D, Marcellin, P, Lerebours, E (2003). Treatment of hepatitis C. The 2002 French consensus. Gut 52: 1784-1787 [Full Text]  
• Henderson, D. K. (2003). Managing Occupational Risks for Hepatitis C Transmission in the Health Care Setting. Clin. Microbiol. Rev. 16: 546-568 [Abstract] [Full Text]  
• Asselah, T, Vidaud, D, Doloy, A, Boyer, N, Martinot, M, Vidaud, M, Valla, D, Marcellin, P (2003). Second infection with a different hepatitis C virus genotype in a intravenous drug user during interferon therapy. Gut 52: 900-902 [Abstract] [Full Text]  
• Vassileva, G., Chen, S.-C., Zeng, M., Abbondanzo, S., Jensen, K., Gorman, D., Baroudy, B. M., Jiang, Y., Murgolo, N., Lira, S. A. (2003). Expression of a Novel Murine Type I IFN in the Pancreatic Islets Induces Diabetes in Mice. J. Immunol. 170: 5748-5755 [Abstract] [Full Text]  
• Cividini, A., Cerino, A., Muzzi, A., Furione, M., Rebucci, C., Segagni, L., Gatti, M., Barnaba, V., Mondelli, M. U. (2003). Kinetics and Significance of Serum Hepatitis C Virus Core Antigen in Patients with Acute Hepatitis C. J. Clin. Microbiol. 41: 2144-2146 [Abstract] [Full Text]  
• Roccasecca, R., Ansuini, H., Vitelli, A., Meola, A., Scarselli, E., Acali, S., Pezzanera, M., Ercole, B. B., McKeating, J., Yagnik, A., Lahm, A., Tramontano, A., Cortese, R., Nicosia, A. (2003). Binding of the Hepatitis C Virus E2 Glycoprotein to CD81 Is Strain Specific and Is Modulated by a Complex Interplay between Hypervariable Regions 1 and 2. J. Virol. 77: 1856-1867 [Abstract] [Full Text]  
• Sester, M., Sester, U., Gartner, B. C., Girndt, M., Meyerhans, A., Kohler, H. (2002). Dominance of Virus-Specific CD8 T Cells in Human Primary Cytomegalovirus Infection. J. Am. Soc. Nephrol. 13: 2577-2584 [Abstract] [Full Text]  
• Sulkowski, M. S., Ray, S. C., Thomas, D. L. (2002). Needlestick Transmission of Hepatitis C. JAMA 287: 2406-2413 [Abstract] [Full Text]  
• Patel, R., Germer, J. J., Tocci, G., Visco-Comandini, U., Antonucci, G., Muir, A. J., Rockey, D. C., Seligman, H. K., Fox, R. K., Cornberg, M., Jaeckel, E., Manns, M. P. (2002). Treatment of Acute Hepatitis C with Interferon Alfa-2b. NEJM 346: 1091-1092 [Full Text]  
• (2001). Early Treatment of Acute HCV with Interferon. JWatch Gastroenterology 2001: 5-5 [Full Text]  
• Hoofnagle, J. H. (2001). Therapy for Acute Hepatitis C. NEJM 345: 1495-1497 [Full Text]  
• (2001). Treatment of Acute Hepatitis C Appears to Be Highly Effective. JWatch General 2001: 1-1 [Full Text]  
• (2001). Pilot Study: Interferon-'{alpha}' Effective for Acute Hepatitis C. JWatch Infect. Diseases 2001: 1-1 [Full Text]