Complete response to twice-a-day interferon-beta with standard interferon-alpha therapy in acute hepatitis C after a...

Area of Science:

• Hepatology
• Virology
• Immunology

Background:

• Acute hepatitis C (HCV) infection poses a significant risk, particularly in healthcare professionals following occupational exposure.
• Genotype 1b HCV infection with high viral loads presents treatment challenges.
• Standard interferon-alpha (IFN-alpha) therapy can be limited by adverse effects like paresthesias.

Observation:

• A 25-year-old male physician developed acute HCV following a needle-stick injury.
• Initial treatment with lymphoblastoid IFN-alpha led to severe paresthesias, necessitating dose reduction.
• Standard IFN-alpha2b therapy for 20 weeks failed to clear HCV RNA.

Findings:

• A subsequent 4-week course of intravenous interferon-beta (IFN-beta), 3 MU twice daily, cleared HCV RNA from serum.
• Adverse effects, including paresthesias, were avoided during IFN-beta treatment.
• A final 18-week course of IFN-alpha2b (6 MU thrice weekly) maintained viral clearance, achieving a complete response.

Implications:

• Combination therapy with IFN-beta and IFN-alpha offers an effective strategy for acute hepatitis C, especially in patients with high viral loads.
• IFN-beta may be a viable option for patients sensitive to IFN-alpha's adverse effects.
• Successful treatment of acute HCV prevents progression to chronic liver disease and reduces transmission risk.