Human serum contains a soluble form of interferon alfa/beta (sIFN ␣/) receptors, the functional and clinical significance of which has not been investigated in patients with chronic hepatitis C. In the present study, serum levels of sIFN ␣/ receptor were assessed in 81 patients with chronic hepatitis C and correlated with the effectiveness of IFN therapy in these patients. Serum levels of sIFN ␣/ receptor were significantly higher in patients with chronic hepatitis C than in healthy control patients (P F .0001). In these patients, serum levels of sIFN ␣/ receptor were correlated with those of alanine transaminase (ALT) (P F .05), (2Ј-5Ј)serum oligo(A) synthetase (2-5AS) (P F .0001), and pathological stages of liver fibrosis (P F .01). In 55 patients with chronic hepatitis C who underwent IFN therapy, there was an inverse correlation between the pretherapeutic serum levels of sIFN ␣/ receptor and the rate of increase in serum levels of 2-5AS after the start of IFN (P F .01). Pretherapeutic serum levels of sIFN ␣/ receptor were significantly lower in patients who showed sustained response to IFN therapy compared with those who did not respond to the therapy (P F .05). Multivariate analysis showed that low levels of serum sIFN ␣/ receptor (I4.0 ng/mL) (P F .05) and serological hepatitis C virus genotype II (P F .05) were independent variables contributing to sustained response to IFN therapy. Thus, pretherapeutic serum levels of sIFN ␣/ receptor were correlated with the effectiveness of IFN therapy, suggesting that sIFN ␣/ receptor suppresses the effectiveness of IFN therapy in patients with chronic hepatitis C. (HEPATOLOGY 1999;30:1325-1331.)Type I interferon (IFN) exerts antiviral and antineoplastic activities, and is involved in immunity control. IFN therapy is currently established as the only effective means of eradicating hepatitis C virus (HCV) from hepatic cells in patients with chronic hepatitis C. However, because the rate of complete cure of the disease accompanied by complete disappearance of HCV RNA from peripheral blood is only 30%, the establishment of a more effective regimen for IFN therapy is warranted. IFN exerts its antiviral activity in target cells via binding to receptors anchored on the outer surface of the cell membrane. 1,2 We and other investigators have previously reported that the effectiveness of IFN therapy in patients with chronic hepatitis C is associated with the amount of type I IFN receptor messenger RNA in the liver. [3][4][5][6] Type I IFN receptor has a multichain structure consisting of at least 2 subunits, AR1 and AR2. 7-10 The AR2 subunit of 100 kd is anchored on the outer surface of the cell membrane and mediates intracellular signal transduction. A soluble form of AR2 proteins of 40 kd, designated soluble IFN alfa/beta (sIFN ␣/) receptor, is found in body fluids including peripheral blood and urine. 11 Novick et al. 9,11,12 showed that sIFN ␣/ receptor molecules inhibited the activity of type I IFN as shown by biological assay with human WISH cells. An IFN-inhi...