Long‐term follow‐up after successful interferon therapy of acute hepatitis C

• Published in: Hepatology (Baltimore, Md.) Vol. 40; no. 1; pp. 98 - 107
• Main Authors: Wiegand, Johannes, Jäckel, Elmar, Cornberg, Markus, Hinrichsen, Holger, Dietrich, Manfred, Kroeger, Julian, Fritsch, Wolfgang P., Kubitschke, Anne, Aslan, Nuray, Tillmann, Hans L., Manns, Michael Peter, Wedemeyer, Heiner
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.07.2004; Wiley
• Subjects: Acute Disease; Adult; Aged; Antibodies, Viral; Antibody Formation; Antibody Specificity; Antiviral Agents - therapeutic use; Biological and medical sciences; Case-Control Studies; CD4-Positive T-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - immunology; Cohort Studies; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Hepacivirus - genetics; Hepacivirus - immunology; Hepatitis C - blood; Hepatitis C - drug therapy; Hepatitis C - immunology; Hepatitis C - virology; Histocompatibility Antigens Class II - analysis; Human viral diseases; Humans; Infectious diseases; Interferon-alpha - therapeutic use; Male; Medical sciences; Middle Aged; RNA, Viral - blood; Treatment Outcome; Viral diseases; Viral hepatitis; Infection; Human; Treatment; Viral disease; Acute; Gastroenterology; Digestive diseases; Hepatic disease; Interferon; Long term; Viral hepatitis C
• ISSN: 0270-9139; 1527-3350
• DOI: 10.1002/hep.20291

Early treatment of acute hepatitis C infection with interferon alfa‐2b (IFN‐α‐2b) prevents chronicity in almost all patients. So far, no data are available on the long‐term outcome after interferon (IFN) therapy of acute hepatitis C. The aim of this study was to assess the clinical, virological, and immunological long‐term outcome of 31 successfully treated patients with acute hepatitis C infection who were followed for a median of 135 weeks (52‐224 weeks) after end of therapy. None of the individuals had clinical evidence of liver disease. Alanine aminotransferase (ALT) levels were normal in all but 1 patient. Serum hepatitis C virus (HCV) RNA was negative throughout follow‐up, even when investigated with the highly sensitive transcription‐mediated amplification (TMA) assay (cutoff 5‐10 IU/mL). In addition, no HCV RNA was detected in peripheral blood mononuclear cells (PBMC) of 15 cases tested. The patients' overall quality‐of‐life scores as determined by the SF‐36 questionnaire did not differ from the German reference control cohort. Ex vivo interferon gamma (IFN‐γ) ELISPOT analysis detected HCV‐specific CD4+ T‐helper cell reactivity in only 35% of cases, whereas HCV‐specific CD8+ T‐cell responses were found in 4 of 5 HLA‐A2–positive individuals. Anti‐HCV antibody levels decreased significantly during and after therapy in all individuals. In conclusion, early treatment of symptomatic acute hepatitis C with IFN‐α‐2b leads to a long‐term virological, biochemical, and clinical response. Waning of anti‐HCV humoral immunity and presence of HCV‐specific CD8+ (but not CD4+) T cells highlights the complexity of T‐cell and B‐cell memory to HCV, which might be significantly altered by IFN treatment. (HEPATOLOGY 2004;40:98–107.)