Treatment of acute hepatitis C virus infection with alpha interferon in patients on hemodialysis.

To evaluate the response to alpha-interferon (INF) in patients who develop acute hepatitis C virus (HCV) infection during hemodialysis, we studied 17 patients who had infection while on dialysis. We administered three million units of alpha interferon subcutaneously to nine adult patients three times per week for 12 weeks; the rest of the patients served as controls. The patients in both groups were followed for 24 months after the diagnosis of seroconversion to anti-HCV antibody. Serum alanine aminotransferase (ALT) levels, anti-HCV antibody levels and HCV- poly chain reaction (HCV-PCR) were performed at regular intervals during the follow-up. Two patients in the treatment group dropped out; one because of colitis and another because of non-compliance. Of the seven patients who completed the course of therapy, all the patients had normal serum ALT levels in 2-8 weeks of therapy, three (42%) patients converted back to anti-HCV antibodies negative and six (86%) had HCV-PCR negative at 12 weeks of therapy (primary virological response) and remained so till the end of follow-up (sustained virological response). The liver biopsy performed in all the responders to therapy at 4-24 months after completion of treatment showed mild hepatitis. In the control group, all the patients continued to have raised serum ALT levels throughout the study; 12% converted anti-HCV antibodies to negative and HCV-PCR (performed on five patients) remained positive during the whole study period. In conclusion our study suggests the efficacy and safety of alpha interferon in the therapy of acute HCV infection in hemodialysis patients.