Efficacy of a 24-week course of PEG-interferon α-2b monotherapy in patients with acute hepatitis C after failure of spontaneous clearance

Background/Aims: Interferon (IFN) monotherapy significantly reduces the chronicity rate of acute hepatitis C (AHC) but optimal regimen and treatment timing remain undefined. The aim of this study was to assess the efficacy of a 6-month course of pegylated IFN (PEG-IFN) alpha-2b monotherapy in AHC patients and to investigate if IFN treatment initiated after 12 weeks from clinical presentation, still achieved a high response rate. Methods: Sixteen AHC patients still viremic after 12 weeks from the onset were treated with PEG-IFN alpha-2b (1.5 mcg/kg once weekly) for 6 months and followed for at least 12 months. Response to therapy was defined as normal ALT values and undetectable HCV RNA (< 50 IU/ml) at the end of therapy, after 6 (sustained response) and 12 months follow-up (long-term response). Results: At the end of treatment, HCV RNA was undetectable in 15/16 patients while ALT normalized in 14/16 patients. After 6 and 12 months follow-up, 15/16 patients (94 %) showed virological and biochemical response. Conclusions: A 6-month course of PEG-IFN alpha-2b is effective in inducing resolution of AHC in 94 % of patients. Our results provide a rationale for delaying treatment for 12 weeks, targeting only patients who fail to clear the virus spontaneously and truly requiring therapy without loss of efficacy. (c) 2004 Published by Elsevier B.V. on behalf of the European Association for the Study of the Liver.