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4819Treatment Article-Marty

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  • 2byteme@bellsouth.net
    Dec 10, 2000
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      Chronic Hepatitis C With Normal
      Serum Enzymes Responds to
      Interferon Therapy

      WESTPORT, CT (Reuters Health) Dec 07 - Hepatitis
      C-infected patients with persistently normal serum interferon
      respond to interferon therapy as well as do similar patients with
      elevated alanine aminotransferase, according to a report in the
      December issue of the Journal of Infectious Diseases.

      Popular opinion suggests that hepatitis C virus (HCV) infection
      accompanied by normal alanine aminotransferase levels is
      relatively benign, the authors explain, but liver biopsies reveal
      cirrhosis in as many as 10% of such patients.

      Dr. Mitchell L. Shiffman and colleagues, from the Medical
      College of Virginia Commonwealth University in Richmond,
      compared the effects of interferon treatment in HCV-infected
      patients with elevated (58 patients) or persistently normal (37
      patients) alanine aminotransferase levels.

      Not surprisingly, hepatic inflammation and fibrosis, as well as
      advanced liver disease, were significantly less common in the
      patients with normal serum alanine aminotransferase levels, the
      report indicates.

      Nevertheless, responses to interferon therapy (as measured by
      serum levels of HCV RNA) were not statistically different for the
      two groups of patients, the authors report. After 3 months of
      treatment, about 38% of both groups of patients were HCV
      RNA-negative. By 18 months after the end of treatment,
      however, only 9.5% of treated patients had a sustained virologic

      Also, 30% of the normal alanine aminotransferase patients
      experienced a rise in serum alanine aminotransferase during the
      study, as did 34% of the group with already elevated serum
      alanine aminotransferase levels, the investigators say.

      "Persons with persistently normal serum alanine aminotransferase
      levels respond to interferon therapy, as do those with elevated
      alanine aminotransferase levels," the authors conclude. "Thus, we
      recommend that patients with chronic HCV infection and
      persistently normal alanine aminotransferase levels undergo liver
      biopsy and be offered treatment, if liver histology is thought to
      warrant this option."

      J Infect Dis 2000;182:1595-1601.