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Evidence summaries

Interferon as Treatment for Acute Hepatitis C

A short course of low-dose interferon administered to patients with acute hepatitis C is significantly more effective than no treatment in obtaining viral clearance and normal aminotransferases 12 months after stopping treatment, but data on clinically important outcomes do not exist. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 6 studies with a total of 206 subjects. When compared with no treatment, interferon alfa-2b was associated with an increase in the rates of virologic activity at the end of treatment (ETR) (by 45%, 95% CI 31 to 59%) and at the end of follow-up (SR) (by 29%, 95% CI 14 to 44%). The virologic ETR was 42% in the interferon alfa-2b group versus 4% in the control group, and virologic SR was seen in 32% of interferon-treated patients versus only 4% of controls.

Comment: Interferon alfa is effective in achieving sustained virological clearance in patients with transfusion-acquired acute hepatitis C. The long-term clinical outcomes could not be assessed due to limitations in the current data.

A systematic review 2 including 5 RCTs with a total of 228 subjects and 4 nonrandomised studies with a total of 133 subjects was abstracted in DARE. The outcomes assessed were number of patients with normalisation of serum ALT and number of patients with clearing of HCV RNA from serum.

For ALT, the overall rate difference was 0.31 (95% CI 0.20 to 0.41). For HCV RNA, the overall rate difference was 0.44 (95% CI 0.33 to 0.56). RCTs and nonrandomised studies yielded similar results. The overall tolerance to interferon alpha was excellent.

Comment: Outcomes of clinical relevance should be assessed in further studies.

References

  • Myers RP, Regimbeau C, Thevenot T, Leroy V, Mathurin P, Opolon P, Zarski JP, Poynard T. Interferon for acute hepatitis C. Cochrane Database Syst Rev. 2001;(4):CD000369.
  • Cammà C, Almasio P, Craxì A. Interferon as treatment for acute hepatitis C. A meta-analysis. Dig Dis Sci 1996 Jun;41(6):1248-55. [PubMed][DARE]

Primary/Secondary Keywords