Treatment of Acute Hepatitis C with Interferon Alfa-2b
Elmar Jaeckel, M.D., Markus Cornberg, M.D., Heiner Wedemeyer, M.D., Teresa Santantonio, M.D., Julika Mayer, M.D., Myrga Zankel, D.V.M., Giuseppe Pastore, M.D., Manfred Dietrich, M.D., Christian Trautwein, M.D., Michael P. Manns, M.D., for the German Acute Hepatitis C Therapy Group
Background In people who are infected with the hepatitis C virus(HCV), chronic infection often develops and is difficult toeradicate. We sought to determine whether treatment during theacute phase could prevent the development of chronic infection.
Methods Between 1998 and 2001, we identified 44 patients throughoutGermany who had acute hepatitis C. Patients received 5 millionU of interferon alfa-2b subcutaneously daily for 4 weeks andthen three times per week for another 20 weeks. Serum HCV RNAlevels were measured before and during therapy and 24 weeksafter the end of therapy.
Results The mean age of the 44 patients was 36 years; 25 werewomen. Nine became infected with HCV through intravenous druguse, 14 through a needle-stick injury, 7 through medical procedures,and 10 through sexual contact; the mode of infection could notbe determined in 4. The average time from infection to the firstsigns or symptoms of hepatitis was 54 days, and the averagetime from infection until the start of therapy was 89 days.At the end of both therapy and follow-up, 43 patients (98 percent)had undetectable levels of HCV RNA in serum and normal serumalanine aminotransferase levels. Levels of HCV RNA became undetectableafter an average of 3.2 weeks of treatment. Therapy was welltolerated in all but one patient, who stopped therapy after12 weeks because of side effects.
Conclusions Treatment of acute hepatitis C with interferon alfa-2bprevents chronic infection.
Source Information
From the Medizinische Hochschule Hannover, Hannover, Germany (E.J., M.C., H.W., J.M., C.T., M.P.M.); the Clinica Malattie Infettive, University of Bari, Bari, Italy (T.S., G.P.); Essex-Pharma, Munich, Germany (M.Z.); and the Bernhard-Nocht Institute, Hamburg, Germany (M.D.).
Address reprint requests to Dr. Manns at the Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover, Carl Neuberg Str. 1, D-30625 Hannover, Germany, or at manns.michael{at}mh-hannover.de.
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