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Treatment of Acute Hepatitis C Appears to Be Highly Effective

In patients with long-standing hepatitis C virus (HCV) infections, even the best antiviral regimens eliminate virus only about half the time. In this industry-sponsored study from Germany, researchers sought to determine whether initiating treatment very early in the clinical course can prevent progression to chronic infection.

The study included 44 patients who presumably had acquired HCV within the previous 4 months, based on criteria such as exposure to a known source or documented seroconversion. All had detectable serum HCV RNA and elevated alanine aminotransferase (ALT) levels. They received interferon alfa-2b (5 million units daily for 4 weeks and then 3 times weekly for 20 weeks) and were followed for an additional 24 weeks after therapy ended. Of 43 patients who completed follow-up, 42 had undetectable HCV RNA and normal ALT levels. Only 1 patient discontinued treatment because of adverse effects.

Comment: These results are remarkable, but caveats are in order. First, there was no control group; however, results from other studies suggest that more than half of patients with acute hepatitis C infections develop chronic infections. Second, post-therapy follow-up was limited to 24 weeks; but, according to studies of patients treated for chronic HCV infections, absence of HCV RNA at this juncture usually indicates a durable response. And third, because patients with acute HCV infections can be asymptomatic, they often are not identified.

— AS Brett

Published in Journal Watch General Medicine October 23, 2001

Citation(s):

Jaeckel E et al. Treatment of acute hepatitis C with interferon alfa-2b. N Engl J Med 2001 Nov 15 345 1452-1457.

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