In this study, researchers from the United States evaluated the efficacy of 2 doses of interferon alpha-2b with ribavirin in patients with chronic hepatitis C and normal ALT.
The team randomized 56 patients with chronic hepatitis C and normal ALT levels to receive either 3 or 5 million units of interferon alpha-2b thrice a week plus ribavirin (1000 to 1200 mg).
They stopped the therapy at 24 weeks if HCV RNA remained detectable; therapy was continued for a further 24 weeks if HCV RNA was undetectable.
|Overall rate of sustained virologic response = 32%.|
|American Journal of Gastroenterology|
The team found that the overall rate of sustained virologic response was 32%.
Sustained virologic response rates were higher in genotype 2 and 3 patients (80%) than in genotype 1 patients (24%).
The researchers observed that there was a tendency toward higher sustained virologic response in genotype 1 patients treated with the higher interferon alpha-2b dose.
Overall, 5 patients had mild, transient ALT elevations, but no sustained ALT elevations were noted.
Dr Ira Jacobson and colleagues concluded, "Patients with normal ALT had a rate of sustained virologic response comparable to that reported in patients with elevated ALT".
"Higher dose of interferon tended to be more effective in genotype 1 infected patients."
"De novo ALT elevations were transient and not clinically significant."
"Patients with chronic hepatitis C should not be excluded from treatment on the basis of ALT alone."
"Combination therapy with pegylated interferon and ribavirin should be evaluated in these patients."