Alpha Interferon in Treatment of Chronic Hepatitis C Viral Infection (CHCV): Pilot Study of 18 Patients

Abstract

Eighteen patients with chronic hepatitis C virus infection (CHCV) were treated with three million units of interferon (IFN) three times a week for a minimum of six months. Four (22.2%) had completely responded, two (11.1%) had partial response and the rest (eight or 44.4%) did not show any evidence of response. After stopping treatment, patients who had a complete or partial response developed a relapse during the follow-up period. Few reversible adverse effects of treatment were reported in more than half of the patients. So, we conclude that three million units of IFN three times weekly is not recommended for treating patients with CHCV. Perhaps a larger dose of five to six million units should be tried and for a longer duration. Ann Saudi Med 1994;14(6):464-466. Since a large number of patients with chronic hepatitis C (CHCV) progress to liver cirrhosis with antecedent risk of hepatocellular carcinoma, 1 there has been a pressing demand to consider treatment proposals. Among these, alpha interferons have shown encouraging results in some studies with complete response achieved in 23% to 48% of patients.2,3 The dosage regime and duration of therapy are yet to be defined. For instance, trials using 3 mU have reported better results than when smaller doses were used, i.e., 1 mU for the same duration of treatment. 4 It is now suggested that a dose of 5 mU to 6 mU three times weekly is desirable, probably for one year. 5The major drawback, however, is the high recurrence rate after cessation of therapy or indeed during the period of therapy.As the number of patients with CHCV in our center is increasing, 6,7 we opted to examine the therapeutic effect of IFN in a pilot study of 18 Saudi patients. They all had serology evidence of HCV and liver biopsy evidence of chronic active hepatitis with or without active cirrhosis. Treatment was given for a minimum of six months and the maximum follow-up period was two years. This preliminary report discusses the outcome of initial phase of therapy. Patients and MethodsTwenty-two consecutive patients with (CHCV) were enrolled in this study, four of whom have been lost to follow-up and only 18 were available for completing the study. There were 12 males and six females. The mean age of the patients was 47.5 years; range 28 to 62 years. The inclusion and exclusion criteria for patients included in the study were: HCV antibody positive, persistently elevated serum aminotransferase (xl.5) for at least six months, chronic hepatitis with or without cirrhosis on liver biopsy.The exclusion criteria were: cirrhosis of child B and C, HBsAg positive, autoimmune markers positive in high titer, previous treatment with interferons, cardiovascular disease, and malignancy.Routine laboratory investigations including full blood counts, liver function tests, especially ALT and AST, HBV markers, anti-HCV, ANA and ultrasound of the abdomen were done for all patients. Antibodies against HCV were determined by enzyme-linked immunosorbent assay (second generation ELISA for anti-HCV, Ortho Diagnostic ...

Severe COVID‐19 represents an undiagnosed primary immunodeficiency in a high proportion of infected individuals

“…Moving forward, the identification of PIDs underlying severe COVID‐19 has significant implications for therapy. Patients with genetic defects that cripple production of type I IFNs, but have intact functioning IFNαR1/IFNαR2 heterodimer, may benefit from cytokine supplementation with exogenous IFN‐α 52 or IFN‐β (may even work for patients with autoantibodies), 67 which are approved for the treatment of hepatitis B, 72 hepatitis C 73 and multiple sclerosis. 74 Patients with autoantibodies against type I IFNs may also be responsive to removal of these antibodies by plasma exchange, 75 and this will include many patients with APECED who have an exceptionally high rate of severe COVID‐19 due to these autoantibodies.…”