October 1, 2001 -- Because of its important clinical implications, the New England Journal of Medicine has released an article about hepatitis C today, a month and a half before the article was due to appear in print in the November 15 issue of the Journal. The essence of the article is that: "Treatment of acute hepatitis C with interferon alfa-2b prevents chronic infection."
Hepatitis C is due to a virus that infects, inflames, and destroys the liver. It is a huge health problem. More than 4 million people in the US and 170 million in the world are currently infected with hepatitis C virus (HCV).
In people infected with HCV, chronic infection often develops and is difficult to eradicate. Chronic hepatitis due to HCV is the most common reason for liver transplantation in the US and Western Europe.
Between 1998 and 2001, the authors of the report in the Journal identified 44 patients throughout Germany who had acute hepatitis C. The average age of the patients was 36 years. Twenty-five were women. Nine became infected with HCV through intravenous drug use, 14 through a needle-stick injury, 7 through medical procedures, and 10 through sexual contact; the mode of infection could not be determined in 4.
The patients received 5 million units of interferon alfa-2b subcutaneously daily for 4 weeks and then three times per week for another 20 weeks. This treatment was well tolerated in all but one patient, who stopped therapy after 12 weeks because of side effects.
To track the HCV virus, HCV RNA levels were measured in blood before therapy, during it, and (for follow-up) 24 weeks after the end of therapy. At the end of therapy and at follow-up, 42 of the 43 (98%) patients who completed follow-up had undetectable levels of HCV RNA in blood and normal liver enzyme levels.
The levels of HCV RNA became undetectable after an average of 3.2 weeks of treatment. On this basis, the authors conclude: "Treatment of acute hepatitis C with interferon alfa-2b prevents chronic infection."
The report is first-authored by Dr. Elmar Jaekel as a member of the German Acute Hepatitis C Therapy Group. Dr. Jaekel is at the Medizinische Hochschule in Hannover, Germany. (The full reference is below).
This report has tremendous implications for everyone with acute hepatitis C. Interferon alfa-2b could save them from developing hepatitis C and cirrhosis, from going into liver failure, and from needing a liver transplant.
Hecht, MD, FAAP
Associate Chief Medical Editor, MedicineNet.com
Reference: Jaeckel E, Cornberg M, Wedemeyer H, Santantonio T, Mayer J, Zankel M, Pastore G, Dietrich M, Trautwein C, Manns MP, and the German Acute Hepatitis C Therapy Group: Treatment of Acute Hepatitis C with Interferon Alfa-2b. New Engl J Med (Published at www.nejm.org October 1, 2001).